Active NPI
Jordan Leigh Bennett, DPT
- Pediatric Physical Therapist
- Lexington, KY
National Provider Identifier
1982956751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- T12031
- Practice address
- 101 Pine St Apt 205
Lexington, KY 40508-3042 - Phone
- (502) 553-1536
- NPI assigned
- Oct 3, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | T12031 | KY | Primary |
Addresses
Primary practice location
101 Pine St Apt 205
Lexington, KY 40508-3042
Mailing address
101 Pine St Apt 205
Lexington, KY 40508-3042
Phone (502) 553-1536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T12031 | KY | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585008000000",
"number": "1982956751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 PINE ST APT 205",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405083042",
"telephone_number": "502-553-1536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 PINE ST APT 205",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405083042",
"telephone_number": "502-553-1536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "JORDAN",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-03",
"last_updated": "2020-03-24",
"certification_date": "2020-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "KY",
"license": "T12031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.