MR. JACK DAVID BENNETT (NPI# 1518167550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518167550 |
| Entity Type | Individual |
| Full Name | MR. JACK DAVID BENNETT |
| Credential | M.D. |
| Practice Address |
617 S Market St #2 Waverly OH 45690-1654 |
| Practice Telephone | 7409411859 |
| Practice Fax Number | 7409411859 |
| Mailing Telephone | 7409411859 |
| Mailing Fax Number | 7409411859 |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 35067134 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0986429 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760006274 | Jack Byron Bennett | Case Manager/Care Coordinator | 5665 Hoover Rd, Grove City, OH 43123-9122 | 2020-06-01 |
| 1972831352 | Jack Bennett Jr. | Pharmacist | 1307 Fm 1092 Rd, Missouri City, TX 77459-1504 | 2009-11-24 |
| 1780895771 | Jack Bennett | Physical Therapist | 11709 Old Ballas Rd, Suite 205, Saint Louis, MO 63141-7029 | 2007-05-24 |
| Street Address |
617 S MARKET ST #2 |
| City | WAVERLY |
| State | OH |
| Zip Code | 45690-1654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767181 | Brandie Mustard | Homemaker | 3018 My Tabor Rd, Waverly, OH 45690 | 2020-10-15 |
| 1225661168 | Kyle Colley | Counselor | 14574 Us Hughway 23, Waverly, OH 45690 | 2020-02-19 |
| 1366082513 | Ryan Rawlins | Counselor | 14574 St. Rt. 23, Waverly, OH 45690 | 2020-01-15 |
| 1700424140 | Jaime Wooldridge | Counselor | 14532 St. Rt. 23, Waverly, OH 45690 | 2019-12-17 |
| 1518513415 | Jacquelyn Irene Sprouse | Counselor | 217 Emmitt Ave, Waverly, OH 45690 | 2019-08-15 |
| 1639634850 | Krista K Leeth | Counselor | 14532 Us Hwy 23, 14534 Us Hwy 23, Waverly, OH 45690 | 2019-02-01 |
| 1881196244 | Kevin Michael Reichert | Counselor | Pike County Recovery Council, 218 East North Street, Waverly, OH 45690 | 2018-03-01 |
| 1619483179 | Ticia Lewis | Counselor | 14532 State Route 23, Waverly, OH 45690 | 2017-12-20 |
| 1205342136 | Criston B Evans | Licensed Practical Nurse | 14532 Us Highway 23, Waverly, OH 45690 | 2017-12-14 |
| 1447763313 | Jody Ryan Colley | Counselor | 14572 St. Rt. 23, Waverly, OH 45690 | 2017-11-14 |
| Find all providers in zip 45690 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821048521 | Nestor Armando Ojeda | Pediatrics | 300 S Clydeton Rd, Waverly, TN 37185-2140 | 2006-05-11 |
| 1265406151 | Mohammad T. Ali | Pediatrics | 227 Valleyview Dr, Waverly, OH 45690 | 2006-02-15 |
| 1801230495 | Premier Care Pediatrics | Pediatrics | 300 S Clydeton Rd, Waverly, TN 37185-2140 | 2013-04-25 |
| 1740323393 | Mary Angela Skelton | Pediatrics | 1034 W Main St, Waverly, TN 37185-1447 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184237968 | Greater Cleveland Pediatrics | Pediatrics | 3311 Richmond Rd, Beachwood, OH 44122-4195 | 2020-08-31 |
| 1528677085 | Mariam Khan | Pediatrics | 2277 Summit St, Columbus, OH 43202-3131 | 2020-07-30 |
| 1447879200 | Amy C Buck | Pediatrics | 30 Kim Ct W, Westerville, OH 43081-2554 | 2020-04-13 |
| 1376170381 | Kathleen Sibyl Kress Farrell | Pediatrics | 14701 Detroit Ave Ste 250, Lakewood, OH 44107-4109 | 2020-03-27 |
| 1710526702 | Rebecca K Cibik | Pediatrics | 2497 State Route 59, Kent, OH 44240 | 2019-12-23 |
| 1992354344 | Rouba Sayegh | Pediatrics | 315 Frankfort Sq, Columbus, OH 43206-1061 | 2019-09-09 |
| 1972164556 | Grace Nikolai | Pediatrics | 9000 N Main St Ste 332, Englewood, OH 45415-1185 | 2019-06-25 |
| 1376012393 | Ohio North East Health Systems, Inc | Pediatrics | 2642 State Route 5, Cortland, OH 44410-9393 | 2018-11-20 |
| 1477022606 | Anthony George Pucell | Pediatrics | 1120 Gordon Rd, Lyndhurst, OH 44124-1335 | 2018-11-16 |
| 1861988875 | Sandeep Randhawa | Pediatrics | Rupert Health Centre, Utmc Campus, 3125, Transverse Drive, Toledo, OH 43614 | 2018-07-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.