Jason D Bennett, MS-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2963-154 Issued in WI

Practice address

2131 S Business Dr
Sheboygan, WI 53081-5656

Phone

(920) 803-1617

Fax

(920) 803-1622

NPI assigned

Nov 19, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Progressive Beginnings, LLC

  • Rehabilitation Clinic/Center
  • Sheboygan, WI
  • NPI 1598886152
  NPD (past)

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1336320258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530815656",
            "telephone_number": "920-803-1617",
            "fax_number": "920-803-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530815656",
            "telephone_number": "920-803-1617",
            "fax_number": "920-803-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JASON",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MS-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2963-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41813000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rieck W Beiersdorf, MD
• David Beimborn, PT
• Julia D. Bell, AUD
• Heidi A Bemis, MD
• Christina Mae Bennett, DMD
• Janeeka Benoit, DO
• Tyler Beranek, D.O.
• Jenna Berens, LPC-IT
• Erin K Berg, RD, CD
• Joseph S Bernstein, M.D.

• All providers in Sheboygan, WI
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.