Edie Knowlton Benner, PHD.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3343 Issued in OH

Practice address

4707 Mill Street
Mantua, OH 44255

Phone

(330) 274-2747

Fax

(330) 274-0337

NPI assigned

Nov 16, 2006

Last updated

Sep 6, 2024By the provider in NPPES

Sex

Female

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 OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Miami, LM Miller School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Rehabilitation and Health Specialists IncGroup PAC ID 3678666807, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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

• Advanced Rehabilitation and Health Specialists Inc

  • Physical Therapist
  • Mantua, OH
  • NPI 1780763763
  Medicare reassignment Care Compare group NPD Authorized official
• Drayer Physical Therapy Northern Ohio LLC

  • Physical Therapist
  • Dayton, OH
  • NPI 1871919969
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1568535862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638",
            "city": "MANTUA",
            "state": "OH",
            "postal_code": "442550638",
            "telephone_number": "330-274-2747",
            "fax_number": "330-274-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 MILL STREET",
            "city": "MANTUA",
            "state": "OH",
            "postal_code": "44255",
            "telephone_number": "330-274-2747",
            "fax_number": "330-274-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER",
        "first_name": "EDIE",
        "middle_name": "KNOWLTON",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "3343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2161922",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aurora Road Group Home
• Kathleen Marie Bailey, RN
• Logan Jamison Bailey, PT, DPT
• Caitlin Barney Fritsch
• Hannah Bell
• Jillann Berns, COTA/L
• Tyler Best
• Deborah Y Bichsel
• Marissa Lilliana Biclawski
• Rachel Bollheimer

• Physical Therapist in Mantua, OH
• Providers in Mantua, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.