Active NPI
Jeani Bennett, ATC, MSED
- Athletic Trainer
- St George, UT
National Provider Identifier
1033508221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 8030326-4810
- Practice address
- 3155 S Hidden Valley Dr Unit 174
St George, UT 84790-6691 - Phone
- (307) 399-4536
- NPI assigned
- Jan 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 8030326-4810 | UT | Primary |
Addresses
Primary practice location
3155 S Hidden Valley Dr Unit 174
St George, UT 84790-6691
Mailing address
883 Churrea Dr
Washington, UT 84780-8127
Phone (307) 399-4536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8030326-4810 | UT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1033508221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "883 CHURREA DR",
"city": "WASHINGTON",
"state": "UT",
"postal_code": "847808127",
"telephone_number": "307-399-4536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3155 S HIDDEN VALLEY DR UNIT 174",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847906691",
"telephone_number": "307-399-4536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "JEANI",
"credential": "ATC, MSED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-12",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "UT",
"license": "8030326-4810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.