DR. WALTER CHARLES JR. BENNETT – Family Nurse Practitioner, NPI 1164569703

DR. WALTER CHARLES JR. BENNETT is a healthcare provider. based in Fayetteville, Tennessee. specializing in NURSE PRACTITIONER. They hold a License No. 355160 (NY). The NPI Number for DR. WALTER CHARLES JR. BENNETT is 1164569703

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
DR. WALTER CHARLES JR. BENNETT
NPI
1164569703
Phone
(931) 251-3009
Address
2310C THORNTON TAYLOR PKWY STE 102
Enumeration Date
31 January 2007
Last Update Date
26 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9312513009
Graduation Year
2024 (2 years ago)
PAC ID
5597852947
Professional Enrollment ID
I20130215000462
Address ID
TN373343668FA2310XPKWY401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience85
Completeness75
Years active:19State licenses:3Digital endpointsOther names

10,656 NURSE PRACTITIONER in TN

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Provider Addresses for DR. WALTER CHARLES JR. BENNETT

  • 2310C THORNTON TAYLOR PKWY STE 102

    FAYETTEVILLE, TN 373343630

    Phone: (931) 251-3009

    Fax: (256) 774-5866

    Type: Mailing

  • 120, West Dublin Drive, Madison, Madison County, Alabama, 35758, United States

    SUITE 102

    MADISON, AL 357583107

    Phone: (256) 774-7189

    Fax: (256) 774-5866

    Type: Mailing

  • 321, West McKnight Drive, Murfreesboro, Rutherford County, Middle Tennessee, Tennessee, 37129, United States

    MURFREESBORO, TN 371292450

    Phone: (615) 890-1189

    Fax: (615) 895-7466

    Type: Location

  • 125 Jerusalem Ave Apt A

    Hicksville, NY 118014958

    Phone: (516) 935-3555

    Type: Location

  • 2310 THORNTON TAYLOR PKWY STE C

    FAYETTEVILLE, TN 373343668

    Phone: (931) 251-3009

    Type: Location

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: 2024-12-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20130215000462INurse PractitionerTNTBD
I20241206002272INurse PractitionerNYTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J7329Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg2,67516$0
99213Established patient office or other outpatient visit, 20-29 minutes57242$0
20611Aspiration and/or injection of fluid large joint using ultrasound guidance37432$0
98925Osteopathic manipulative treatment, 1-2 body regions26226$0
98926Osteopathic manipulative treatment, 3-4 body regions7017$0
View full utilization report →

Insurance plans in this area (ZIP 37334)

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Provider's Procedures

DR. WALTER CHARLES JR. BENNETT performs procedures in NURSE PRACTITIONER. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NURSE PRACTITIONERTN98926Osteopathic manipulative treatment to 3-4 body regions25529

Reviews

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Frequently asked questions

Does DR. WALTER CHARLES JR. BENNETT share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. WALTER CHARLES JR. BENNETT uses 1164569703.
Is DR. WALTER CHARLES JR. BENNETT still practicing?
DR. WALTER CHARLES JR. BENNETT is currently listed as active in the public NPI registry.
What is DR. WALTER CHARLES JR. BENNETT's primary classification?
Family Nurse Practitioner is the headline specialty for DR. WALTER CHARLES JR. BENNETT here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. WALTER CHARLES JR. BENNETT?
DR. WALTER CHARLES JR. BENNETT's geographic hint is Fayetteville, Tennessee in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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