Individual provider Active NPI

Kelsi Lyn Bennett, PT, DPT

  • Physical Therapist
  • Lees Summit, MO
National Provider Identifier
1629564372
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2018025702 Issued in MO
Practice address
800 NW Main St Ste 100
Lees Summit, MO 64086-9301
Phone
(816) 524-7040
Fax
(816) 524-7057
NPI assigned
Jul 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-05949 KS
Physical Therapist 225100000X 2018025702 MO Primary

Addresses

Primary practice location

800 NW Main St Ste 100
Lees Summit, MO 64086-9301

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217

Other practice location 1

1300 N 7 Hwy Ste 100
Blue Springs, MO 64014-2282
Phone (816) 524-7040

Other names 1

  • Kelsi Lyn Martin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180723001907 MO Practitioner - Physical Therapist in Private Practice 7618224627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Strength Physical Therapy LLCGroup PAC ID 8224086772, 14 clinicians

Practice addresses (Care Compare)

800 NW Main St
Suite 100
Lees Summit, MO 64086-9301
Phone (816) 524-7040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Strength Physical Therapy, LLC Physical Therapist CurrentSince May 31, 2022 Accepting new patients

Locations

1300 NW State Route 7
Ste 100
Blue Springs, MO 64014
Phone (816) 524-7040

800 NW Main St
Ste 100
Lees Summit, MO 64086
Phone (816) 524-7040

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1629564372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 NW MAIN ST STE 100",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640869301",
            "telephone_number": "816-524-7040",
            "fax_number": "816-524-7057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 N 7 Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "640142282",
            "country_code": "US",
            "telephone_number": "816-524-7040",
            "fax_number": "816-524-7057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KELSI",
        "middle_name": "LYN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-05949",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2018025702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSI",
            "last_name": "MARTIN",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lees Summit, MO

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.
  • 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.