Individual provider Active NPI

Leah Bennett

  • Family Nurse Practitioner
  • Festus, MO
National Provider Identifier
1649069915
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025014697 Issued in MO
Practice address
120 Blue Ridge Trce
Festus, MO 63028-4700
Phone
(314) 210-8553
NPI assigned
May 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025014697 MO Primary

Addresses

Primary practice location

120 Blue Ridge Trce
Festus, MO 63028-4700

Mailing address

120 Blue Ridge Trce
Festus, MO 63028-4700
Phone (314) 210-8553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251030003059 MO Practitioner - Nurse Practitioner 1456840362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12 Jefferson SQ
De Soto, MO 63020-1031

1500 Calvary Church Rd
Festus, MO 63028-4125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025014697MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Medical Providers LLC Family CurrentSince Aug 4, 2025 Accepting new patients

Locations

2001 N Kingshighway St
Cpe Girardeau, MO 63701
Phone (573) 335-1999

1349 US Highway 61
Crystal Cty, MO 63028
Phone (636) 937-3500

783 Weber Rd
Farmington, MO 63640
Phone (573) 756-8997

5408 S Broadway
Saint Louis, MO 63111
Phone (314) 353-7225

1100 Progress Pkwy
Ste Genevieve, MO 63670
Phone (573) 883-3454

Organizations & group practices 2

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": "1746230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1649069915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BLUE RIDGE TRCE",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284700",
            "telephone_number": "314-210-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BLUE RIDGE TRCE",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284700",
            "telephone_number": "314-210-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LEAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-03",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025014697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.