Ethan Conner Bennett, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTT40306 Issued in FL

Practice address

5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305

Phone

(813) 978-9700

Fax

(813) 978-9700

NPI assigned

Jun 8, 2023

Sex

Male

Sole proprietor

No

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

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Musculoskeletal Institute Chartered

  • Orthopaedic Surgery Physician
  • Temple Terrace, FL
  • NPI 1386639920
  Medicare reassignment NPD
• Tallahassee Orthopedic Clinic III PL

  • Medical Specialty Clinic/Center
  • Tallahassee, FL
  • NPI 1194778050
  Medicare reassignment NPD
• Musculoskeletal Institute Chartered

  • Orthopaedic Surgery Physician
  • Zephyrhills, FL
  • NPI 1467305839
  NPD
• Tallahassee Orthopedic Clinic III, P.L.

  • Durable Medical Equipment & Medical Supplies
  • Panama City Beach, FL
  • NPI 1497617948
  NPD

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1285328526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 E FOWLER AVE STE 100",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172305",
            "telephone_number": "813-978-9700",
            "fax_number": "813-978-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 E FOWLER AVE STE 100",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172305",
            "telephone_number": "813-978-9700",
            "fax_number": "813-978-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ETHAN",
        "middle_name": "CONNER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PTT40306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PTT40306",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Luis Beltran, D.M.D., M.D.
• Luis Gabriel Beltran, MD
• Benaiah Healthcare LLC
• Mallelin Bengochea, APRN
• Eisy Ivonne Benitez
• Maria D Bentley, RBT
• Agnes Sharon Berlin, MD
• Thomas L Bernasek, MD
• Chelsea Renee Berry
• Hailey D Bess, APRN

• Physical Therapist in Temple Terrace, FL
• Providers in Temple Terrace, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.