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Deactivated NPI 1457014490 Deactivated / Inactive NPI Male Practitioner

Robert Tyler Bennett

Peer Specialist • Louisa, KY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Robert Bennett has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 18, 2021
NPI Deactivation Date March 15, 2023
Total Practice Duration ~2 Years of Practice (2021 – 2023)

Professional Overview & Biography Verified Profile Summary

Robert Bennett was a registered Peer Specialist practicing in Louisa, KY. Throughout an active medical career spanning 2 years, Robert Bennett provided care at the practice location at 125 S MAIN CROSS ST until profile deactivation on 2023-03-15.

Practice Location & Contact Primary Location

Practice Address

125 S Main Cross St

Louisa, KY 412301065

Telephone 6066380938
Associated Practice Facility / Clinic
🏢 Odyssey Inc Facility NPI 1669754248

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Louisa, KY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
795 Specialists

Practicing in Louisa, KY (1987 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Lois Hubbard

Case Manager/Care Coordinator

NPI 1003034950
Charlotte Williamson , LPCA

Counselor - Professional

NPI 1003165119
John Riley , CADC

Counselor - Addiction (Substance Use Disorder)

NPI 1003240953

Certified Alcohol and Drug Counselor

Richard Skeens

Peer Specialist

NPI 1003469321
Keith Jones

Peer Specialist

NPI 1003523994
Bobby Hill , PSS

Peer Specialist

NPI 1003547258

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 15, 2023

Record deactivated on March 15, 2023

NPI Profile Active October 18, 2021

NPI status registered as active in NPPES database

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Updated Practice Location October 18, 2021

Registered at 125 S MAIN CROSS ST, LOUISA, KY 412301065 (Tel: 6066380938)

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Updated Business Mailing Address October 18, 2021

Registered at 125 S MAIN CROSS ST, LOUISA, KY 412301065

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Provider Name / Credentials Updated October 18, 2021

Recorded as ROBERT BENNETT

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 18, 2021

Peer Specialist

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Initial NPI Registration & Enumeration October 18, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1457014490
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 18, 2021
Last Update: October 18, 2021
Deactivation Date: March 15, 2023

Mailing Address

125 S Main Cross St

Louisa, KY 412301065

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.