Blake Bennett, PT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

13112 Issued in TN

Practice address

871 Ridgeway Loop Rd Ste 100
Memphis, TN 38120-4026

Phone

(901) 266-3838

NPI assigned

Nov 3, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Rehab, Etc., Inc.

  • Physical Therapist
  • Memphis, TN
  • NPI 1104032465
  NPD

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1508467937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 RIDGEWAY LOOP RD STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 RIDGEWAY LOOP RD STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204026",
            "telephone_number": "901-266-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BLAKE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2021-12-09",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TN",
            "license": "13112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bengal Hospitalist
• Anna Francesca Bengert, RN
• Eric H Benink, M.D.
• Jorge Benitez Jr., M.D.
• Jerry D Benitone, M.D.
• Denise A Bennett, BS
• Jessica Gibbs Bennett, PHARMD.
• Julie Leighann Bennett, PHARMD
• Morgan Bennett, FNP-C, CPNP-AC
• Myra Lyn Bennett, LCPT

• Physical Therapy Clinic/Center in Memphis, TN
• Providers in Memphis, TN by specialty
• Physical Therapy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.