Kelly M Bennett, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

58177 Issued in KY

Practice address

2724 Nashville Rd
Bowling Green, KY 42101-4000

Phone

(270) 781-5111

NPI assigned

Apr 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kellybennett@ggc.allscriptsdirect.net

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.

• Graves Gilbert Clinic PLLC

  • Specialist
  • Bowling Green, KY
  • NPI 1114948288
  Medicare reassignment Care Compare group NPD
• Graves Gilbert Clinic PLLC

  • Rural Health Clinic/Center
  • Cave City, KY
  • NPI 1104635663
  NPD
• Bowling Green-Warren County Community Hospital Corporation

  • General Acute Care Hospital
  • Bowling Green, KY
  • NPI 1043293608
  NPD (past)

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1306136460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011708",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 NASHVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014000",
            "telephone_number": "270-781-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35122871",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "58177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114738",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lynn Belt, LPCA
• Benchmark Physical Therapy of Ky LLC
• Benchmark Physical Therapy of Ky LLC
• James Bender, LPA
• Ashley J Bennett, M.D.
• Mary P Bennett, PHD, ARNP
• Patrick J. Bennett, M.D.
• Charles E. Benneyworth, M.D.
• Laura Chinn Benningfield
• Alyssa D Benton

• Pediatrics Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.