Thomas Omer Bennett, PH. D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

20040100A Issued in IN

Practice address

50 Markleville LN
Westfield, IN 46074-8433

Phone

(317) 775-3711

NPI assigned

Jun 28, 2007

Last updated

Sep 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1275730756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MARKLEVILLE LN",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460748433",
            "telephone_number": "317-775-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MARKLEVILLE LN",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460748433",
            "telephone_number": "317-775-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "THOMAS",
        "middle_name": "OMER",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20040100A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "103TC0700X - PSYCHOLOGIST - CLINICAL",
            "identifier": "20040100A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Westfield, IN
• Providers in Westfield, IN by specialty
• Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.