Kerry D. Bennett, DO

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

02001168A Issued in IN

Practice address

3600 W Bethel Ave
Muncie, IN 47304-5407

Phone

(765) 284-7738

Fax

(765) 213-3713

NPI assigned

Jul 31, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1689680563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6280 S 625 W",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460648972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407",
            "telephone_number": "765-284-7738",
            "fax_number": "765-213-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KERRY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "02001168A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "200043532",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000209731",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200359010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Bell, FNP
• Kyle Bell, RBT
• Michelle Belt, MA CCC-SLP
• Betsy Benitez
• Anteysa Bennett
• Bergan Counseling Services LLC
• Jamie Bergan
• Jama Elizabeth Berkemeier, NP-C
• Jonathan Laurence Berkowitz, M.D., PH.D.
• Nicholas Berlon, M.D.

• Sports Medicine (Orthopaedic Surgery) Physician in Muncie, IN
• Providers in Muncie, IN by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.