Mary Kathryn Frey Bennett, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT016016 Issued in GA

Practice address

94 Main St
Gorham, ME 04038-1340

Phone

(207) 839-5860

Fax

(207) 839-2499

NPI assigned

Jul 18, 2022

Sex

Female

Sole proprietor

No

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

Enrolled in ME

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Back in Motion Physical Therapy LLCGroup PAC ID 7416926704, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Back in Motion Physical Therapy, LLC

  • Physical Therapist
  • Gorham, ME
  • NPI 1821165960

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Therapy Spot LLC

  • Speech-Language Pathologist
  • Statesboro, GA
  • NPI 1083996755
  NPD

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1851026496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 NICOLIN RD",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046053113",
            "telephone_number": "774-200-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 MAIN ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381340",
            "telephone_number": "207-839-5860",
            "fax_number": "207-839-2499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 Gentilly Rd",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304585149",
            "country_code": "US",
            "telephone_number": "912-681-7768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARY KATHRYN",
        "middle_name": "FREY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT016016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Beane, LCSW
• Abby M Beaumont, LCSW
• Elizabeth Beaven
• Lisa Belanger, FNP
• Amber S Bell, P.T.
• Kirsten Bombardier Benson
• Brandi Marie Bessey
• Alana Bickford Patterson
• Ashley Blanchard, LCPC-C
• Amy Blodgett, FNP-C

• Pediatric Physical Therapist in Gorham, ME
• Providers in Gorham, ME by specialty
• Pediatric Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.