Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Walter Charles Bennett Jr.

Individual provider Family Nurse Practitioner · NPI 1164569703

Dr. Walter Charles Bennett Jr. is a Nurse Practitioner in Fayetteville, Tennessee. Qualified in 2024, 2 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Alabama, New York and Tennessee.

Years since qualifying
2
Licensed in
AL, NY, TN
In the registry since
2007
Specialties on file
3
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Practice location Address checks out

2310 Thornton Taylor Pkwy Ste C
Fayetteville, TN 37334-3668
Phone: (931) 251-3009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 125 Jerusalem Ave Apt A, Hicksville, NY 11801-4958 — (516) 935-3555

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 16762 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 355160 (NY)
Chiropractor Taxonomy 111N00000X · Licence 2025 (AL)

Record details

NPI number1164569703
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 31, 2007
Last updated in NPPESSeptember 26, 2024
Certification dateSeptember 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fayetteville