J Bennett Group PSC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

129055 Issued in KY

Legal business name

J BENNETT GROUP PSC

Practice address

1169 Eastern Pkwy Ste 2238
Louisville, KY 40217-1444

Phone

(502) 376-7552

Fax

(502) 425-5540

NPI assigned

Mar 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jeanne M Bennett, PSYD

Title

Pres/Ceo

Phone

(502) 376-7552

Specialties & licenses 3

Addresses

Other identifiers 4

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Margaret Elizabeth Smedley, PH.D.

  • Psychologist
  • Louisville, KY
  • NPI 1851589691
  NPD (past)
• Dennis E Wagner, ED.D.

  • Clinical Psychologist
  • Louisville, KY
  • NPI 1184649402
  NPD (past)
• Marilyn M Wagner, PH.D.

  • Clinical Neuropsychologist
  • Louisville, KY
  • NPI 1598757213
  NPD (past)

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1790955334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 STEVENS AVE",
            "address_2": "SUITE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051087",
            "telephone_number": "502-376-7552",
            "fax_number": "502-425-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY STE 2238",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171444",
            "telephone_number": "502-376-7552",
            "fax_number": "502-425-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J BENNETT GROUP PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRES/CEO",
        "authorized_official_telephone_number": "502-376-7552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "1034",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "129055",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1034",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89900344",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000376780",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH",
            "identifier": "50107908",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7944828",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iyer Neurology PLLC
• Megana Rajam Iyer
• Sharanya Iyer, MMSC
• Vasudeva G. Iyer, M.D.
• Yamilka M Izquierdo
• J Gendeman LLC
• J L Schorch LCSW PSC
• J Mason & Associates
• J P McCubbin MD PLLC
• J. Allen Bridgman Pediatric Speech Pathology, PLLC

• Clinical Neuropsychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Neuropsychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.