| Kenneth W Bennett, CRNA | |
|
5 Mobile Infirmary Cir, Mobile, AL 36607-3513 | |
| (251) 432-4497 | |
| (251) 432-0577 |
| Full Name | Kenneth W Bennett |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 21 Years |
| Location | 5 Mobile Infirmary Cir, Mobile, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942254263 | NPI | - | NPPES |
| 009935493 | Medicaid | AL | |
| 051532707 | Other | AL | BC OF ALABAMA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 1-072095 (Alabama) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 1072095 (Alabama) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mobile Infirmary Medical Center | Mobile, AL | Hospital |
| Springhill Medical Center | Mobile, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Blue Lake Health Springhill Llc | 2365830007 | 41 |
| Anesthesiologists Associated Pc | 6204739519 | 346 |
| Entity Name | Anesthesiologists Associated Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851371850 PECOS PAC ID: 6204739519 Enrollment ID: O20040202000465 |
| Entity Name | Houston County Healthcare Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619026606 PECOS PAC ID: 9436062296 Enrollment ID: O20040219000209 |
| Entity Name | Providence Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952390643 PECOS PAC ID: 9830111871 Enrollment ID: O20051219000880 |
| Entity Name | Usa Health Anesthesia Billing Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629635818 PECOS PAC ID: 1153659123 Enrollment ID: O20190829000530 |
| Entity Name | Blue Lake Health Springhill Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194496216 PECOS PAC ID: 2365830007 Enrollment ID: O20211028001840 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth W Bennett, CRNA Po Box 934369, Atlanta, GA 31193-0001 Ph: (800) 897-6169 | Kenneth W Bennett, CRNA 5 Mobile Infirmary Cir, Mobile, AL 36607-3513 Ph: (251) 432-4497 |