Marisa Jo Bennett

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2018029762 Issued in MO

Practice address

1306 Amber LN
Kearney, MO 64060-7672

Phone

(816) 804-7311

NPI assigned

Aug 12, 2022

Last updated

Aug 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1821726282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 AMBER LN",
            "city": "KEARNEY",
            "state": "MO",
            "postal_code": "640607672",
            "telephone_number": "816-804-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 AMBER LN",
            "city": "KEARNEY",
            "state": "MO",
            "postal_code": "640607672",
            "telephone_number": "816-804-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARISA",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2018029762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John D Barth, DO
• Jamieca Del Pilar Bascos, BSPT
• Rachel Lee Bears, MPT
• Bennett Eyecare Midwest LLC
• Angela Bennett
• Christina Joan Blanton
• Brenda Jean Boswell, M.S., CCC-SLP
• Barry Vincent Bowles, O.D.
• Dolores E Branscom, PTA
• Larry Briscoe

• Speech-Language Pathologist in Kearney, MO
• Providers in Kearney, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.