Active NPI
Stacy Bennett
- Physical Therapist
- Goddard, KS
National Provider Identifier
1144969312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-01941
- Practice address
- 12 S Lakeview CT
Goddard, KS 67052-9228 - Phone
- (316) 252-0445
- NPI assigned
- Jun 3, 2022
- Last updated
- Jun 3, 2022
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-01941 | KS | Primary |
Addresses
Primary practice location
12 S Lakeview CT
Goddard, KS 67052-9228
Mailing address
1446 N Cedar Park Cir
Wichita, KS 67235-1209
Phone (131) 673-4177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12 S Lakeview CT
Goddard, KS 67052-9228
Phone (316) 252-0445
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkinsons Connect | Physical Therapist | Current | Accepting new patients |
| Parkinson Consulting and Rehab | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Parkinson Connect
- Occupational Medicine Clinic/Center
- Goddard, KS
- NPI 1851981922
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654214400000",
"number": "1144969312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1446 N CEDAR PARK CIR",
"city": "WICHITA",
"state": "KS",
"postal_code": "672351209",
"telephone_number": "131-673-4177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 S LAKEVIEW CT",
"city": "GODDARD",
"state": "KS",
"postal_code": "670529228",
"telephone_number": "316-252-0445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "STACY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-03",
"last_updated": "2022-06-03",
"certification_date": "2022-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-01941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goddard, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.