PATRISE BENNETT (MD) – Family Medicine Physician, NPI 1407878747

PATRISE BENNETT (MD) is a healthcare provider. based in Jackson, Mississippi. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. 15488 (MS). The NPI Number for PATRISE BENNETT (MD) is 1407878747

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
PATRISE BENNETT (MD)
NPI
1407878747
Phone
(601) 957-3333
Address
5606 OLD CANTON RD
Enumeration Date
24 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
6013710400
Graduation Year
1996 (30 years ago)
PAC ID
6507045002
Group Practice PAC ID
0941583728
Professional Enrollment ID
I20110131000498
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for PATRISE BENNETT (MD)

  • 5606, Old Canton Road, Rolling Meadows, Jackson, Hinds County, Mississippi, 39211, United States

    JACKSON, MS 392114217

    Phone: (601) 957-3333

    Fax: (601) 957-3334

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110131000498IFamily PracticeMSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 39211)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941583728View full group profile
NameSpecialtyState
Family Practice, Emergency MedicineMS
-MS
Nurse PractitionerMS
-MS
Family PracticeMS
Physician AssistantMS
Family PracticeFL
-MS
-MS
Family PracticeMS

Reviews

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Frequently asked questions

Where can patients find PATRISE BENNETT (MD)'s NPI?
You can confirm PATRISE BENNETT (MD) with NPI 1407878747; it appears in the national provider directory.
Is PATRISE BENNETT (MD)'s NPI currently valid?
The extract we use shows PATRISE BENNETT (MD) as active.
Can you summarize PATRISE BENNETT (MD)'s specialty in plain language?
Clinically, the directory lists PATRISE BENNETT (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for PATRISE BENNETT (MD)?
We surface Jackson, Mississippi for PATRISE BENNETT (MD) based on available NPPES addresses.
How can I contact PATRISE BENNETT (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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