Active NPI
Kelly A Bennington, PA
- Physician Assistant
- Springfield, OH
National Provider Identifier
1679056188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2701 Moorefield Rd
Springfield, OH 45502-8207 - Phone
- (937) 399-6650
- Fax
- (937) 399-8558
- NPI assigned
- Sep 11, 2018
- Last updated
- Sep 11, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | OH | Primary |
Addresses
Primary practice location
2701 Moorefield Rd
Springfield, OH 45502-8207
Mailing address
2701 Moorefield Rd
Springfield, OH 45502-8207
Phone (937) 399-6650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
4700 Springboro Pike
Suite C
Moraine, OH 45439-1982
Phone (833) 505-4673
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Addiction Medicine (Internal Medicine) Physician
- Moraine, OH
- NPI 1558800193
-
- Pain Clinic/Center
- Dayton, OH
- NPI 1790730638
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536624000000",
"number": "1679056188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 MOOREFIELD RD",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455028207",
"telephone_number": "937-399-6650",
"fax_number": "937-399-8558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 MOOREFIELD RD",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455028207",
"telephone_number": "937-399-6650",
"fax_number": "937-399-8558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNINGTON",
"first_name": "KELLY",
"middle_name": "A",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-11",
"last_updated": "2018-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.