Active NPI
Kathy Jo Bennett, NP
- Critical Care Medicine Nurse Practitioner
- Dayton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Nurse Practitioner
- License
- 279294
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201069120 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 206624 | TN | MD | Nurse Practitioner |
| 71003950A | IN | MD | Acute Care Nurse Practitioner |
| 279294 | OH | MD | Gerontology Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PHS Emergency Billing LLC | Nurse Practitioner | Current | Accepting new patients |
| Ohiohealth Corporation | Current | Accepting new patients | |
| Ohiohealth Corporation | Current | Accepting new patients | |
| Emergency Medicine Services of TN, PC | Current | 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.
-
- Family Medicine Physician
- Columbus, OH
- NPI 1578545273
-
- Emergency Medicine Physician
- Nashville, TN
- NPI 1720785884
-
- Emergency Medicine Physician
- Dayton, OH
- NPI 1821189085
-
- Anesthesiology Physician
- Columbus, OH
- NPI 1407292105
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.