Active NPI
Angelina Michelle Benjamin
- Case Manager/Care Coordinator
- Anchorage, AK
National Provider Identifier
1013413129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- CERTIFICATE
- Practice address
- 1515 E Tudor Rd Ste 6
Anchorage, AK 99507-1036 - Phone
- (907) 332-0065
- Fax
- (907) 782-4522
- NPI assigned
- Apr 5, 2018
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CERTIFICATE | AK | Primary |
Addresses
Primary practice location
1515 E Tudor Rd Ste 6
Anchorage, AK 99507-1036
Mailing address
1515 E Tudor Rd Ste 6
Anchorage, AK 99507-1036
Phone (907) 332-0065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6919734 | Other | AK | STATE ISSUED DRIVERS LICENSE |
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 |
|---|---|---|---|
| CERTIFICATE | AK | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522886400000",
"number": "1013413129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 E TUDOR RD STE 6",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995071036",
"telephone_number": "907-332-0065",
"fax_number": "907-782-4522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 E TUDOR RD STE 6",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995071036",
"telephone_number": "907-332-0065",
"fax_number": "907-782-4522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "ANGELINA",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-05",
"last_updated": "2018-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "AK",
"license": "CERTIFICATE",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE ISSUED DRIVERS LICENSE",
"identifier": "6919734",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.