Benton Stoutamire, CNIM

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Practice address

420 Charter Blvd Ste 402a
Macon, GA 31210-4854

Phone

(478) 273-3831

Fax

(303) 922-4640

NPI assigned

Sep 19, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Guardion Medical

  • Electroneurodiagnostic Specialist/Technologist
  • Macon, GA
  • NPI 1699394825
  NPD
• Neurodiagnostic Consultants, LLC

  • Neurology Physician
  • Marietta, GA
  • NPI 1881928646

  Electroneurodiagnostic

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1023566007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CHARTER BLVD STE 402A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104854",
            "telephone_number": "478-273-3831",
            "fax_number": "855-940-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CHARTER BLVD STE 402A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104854",
            "telephone_number": "478-273-3831",
            "fax_number": "303-922-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUTAMIRE",
        "first_name": "BENTON",
        "name_prefix": "Mr.",
        "credential": "CNIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-19",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Allen Stokes, M.D.
• Kelsey Jayce Stone, LCSW
• Natasha Tiffany Stone, MD
• Rafeal Stone
• Christina Stonecypher
• Michael Lee Strange, PHARMD.
• Sierra Logan Stratton, MD
• Loy Daniel Strawn, MD
• Hailey Annalyn Stringer, APRN
• Denise Stroud, IBCLC

• Electroneurodiagnostic Specialist/Technologist in Macon, GA
• Providers in Macon, GA by specialty
• Electroneurodiagnostic Specialist/Technologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.