Individual provider Active NPI

Avery Elisabeth Bennington

  • Speech-Language Pathologist
  • Newark, OH
National Provider Identifier
1710869482
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
COND.20253166-SP Issued in OH
Practice address
145 N Quentin Rd
Newark, OH 43055-4623
Phone
(740) 349-6084
NPI assigned
Jul 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X COND.20253166-SP OH Primary

Addresses

Primary practice location

145 N Quentin Rd
Newark, OH 43055-4623

Mailing address

3830 S Bank Rd NE
Millersport, OH 43046-8035
Phone (740) 618-3377

Other practice location 1

300 Licking View Dr
Heath, OH 43056-1534
Phone (740) 238-7150

Other practice location 2

1510 Licking Valley Rd
Newark, OH 43055-9434
Phone (740) 763-2865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
COND.20253166-SPOHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1710869482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 S BANK RD NE",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430468035",
            "telephone_number": "740-618-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N QUENTIN RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430554623",
            "telephone_number": "740-349-6084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Licking View Dr",
            "address_purpose": "LOCATION",
            "city": "Heath",
            "state": "OH",
            "postal_code": "430561534",
            "country_code": "US",
            "telephone_number": "740-238-7150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1510 Licking Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430559434",
            "country_code": "US",
            "telephone_number": "740-763-2865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNINGTON",
        "first_name": "AVERY",
        "middle_name": "ELISABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND.20253166-SP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.