Jason Eugene Bennett, MSPT SCS ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

119668 Issued in MO

Practice address

3437 Caroline St
Saint Louis, MO 63104-1111

Phone

(314) 977-8652

NPI assigned

Aug 31, 2006

Last updated

Jul 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1609987650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 LEONARD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191538",
            "telephone_number": "314-459-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3437 CAROLINE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041111",
            "telephone_number": "314-977-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JASON",
        "middle_name": "EUGENE",
        "credential": "MSPT SCS ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "119668",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2008003299",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delores Ardith Elena Bennett, LPN
• Edward Strachan Bennett, OD
• Elizabeth J Bennett, LPC
• Heather Bennett
• Jack Bennett, PT
• Justin M Bennett, LCSW
• Kenneth J Bennett, MD
• Linda Jean Bennett
• Malissa Bennett
• Michael Charles Bennett, MD

• Physical Therapist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.