Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Mary Keely Costello Bennett, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1417398124

Mrs. Mary Keely Costello Bennett, AGACNP-BC is a Nurse Practitioner in Richmond, Virginia. Qualified in 2013, 13 years ago. Practices with Mcv Associated Physicians, a 1,767-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
13
Licensed in
VA
In the registry since
2013
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Practice location Address checks out

1250 E Marshall St Emergency Medicine
Richmond, VA 23298-5051
Phone: (804) 828-5650
Fax: (804) 828-4686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 0024170989 (VA)

Record details

NPI number1417398124
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedJuly 10, 2013
Last updated in NPPESFebruary 7, 2019

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice McV Associated Physicians — 1767 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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