Individual provider Active NPI

Kathy Jo Bennett, NP

  • Critical Care Medicine Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1871887463
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
279294 Issued in OH
Practice address
1 Wyoming St
Dayton, OH 45409-2722
Phone
(937) 208-8000
NPI assigned
Jun 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 279294 OH Primary
Acute Care Nurse Practitioner 363LA2100X 71003950A IN
Nurse Practitioner 363L00000X 206624 TN

Addresses

Primary practice location

1 Wyoming St
Dayton, OH 45409-2722

Mailing address

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000

Other identifiers 1

IdentifierTypeStateIssuer
201069120MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110729000186 OH Practitioner - Nurse Practitioner 5294903621 Reassigns benefits to 3 organizations
I20160122000842 TN Practitioner - Nurse Practitioner 5294903621 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
206624TNMDNurse Practitioner
71003950AINMDAcute Care Nurse Practitioner
279294OHMDGerontology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
PHS Emergency Billing LLC Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 1, 2024 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 1, 2024 Accepting new patients
Emergency Medicine Services of TN, PC CurrentSince Apr 1, 2023 Accepting new patients

Locations

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

Dept L3652
Columbus, OH 43260

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

4940 Cottonville Rd
Jamestown, OH 45335
Phone (937) 298-4417

300 Austin West Blvd
Miamisburg, OH 45342
Phone (937) 388-7911

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

107 Natchez Park Dr
Dickson, TN 37055
Phone (615) 326-2900

111 Highway 70 E
Dickson, TN 37055
Phone (615) 441-2357

355 New Shackle Island Rd
Hendersonvlle, TN 37075
Phone (615) 264-4000

5655 Frist Blvd
Hermitage, TN 37076
Phone (615) 316-3541

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

3441 Dickerson Pike
Nashville, TN 37207
Phone (615) 234-6426

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1871887463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KATHY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "OH",
            "license": "279294",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71003950A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "206624",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201069120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.