Active NPI
Martell Bennion, SLP MA-CCC
- Speech-Language Pathologist
- St George, UT
National Provider Identifier
1558094730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 109875-4102
- Practice address
- 951 E Brigham Rd
St George, UT 84790-8454 - Phone
- (435) 673-1557
- NPI assigned
- Jul 6, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 109875-4102 | UT | Primary |
Addresses
Primary practice location
951 E Brigham Rd
St George, UT 84790-8454
Mailing address
951 East Brigham Road
St. George, UT 84790
Phone (435) 673-1557
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109875-4102 | UT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657065600000",
"number": "1558094730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "951 EAST BRIGHAM ROAD",
"city": "ST. GEORGE",
"state": "UT",
"postal_code": "84790",
"telephone_number": "435-673-1557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "951 E BRIGHAM RD",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847908454",
"telephone_number": "435-673-1557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNION",
"first_name": "MARTELL",
"credential": "SLP MA-CCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-06",
"last_updated": "2022-07-06",
"certification_date": "2022-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "UT",
"license": "109875-4102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.