Individual provider Active NPI

Ben Bonnie O'Neal, LPN

  • Licensed Practical Nurse
  • Mayfield HTS, OH
National Provider Identifier
1033210992
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN108513 Issued in OH
Practice address
6809 Mayfield Rd
952
Mayfield HTS, OH 44124-2266
Phone
(440) 442-0743
Fax
(440) 442-0905
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN108513 OH Primary

Addresses

Primary practice location

6809 Mayfield Rd
952
Mayfield HTS, OH 44124-2266

Mailing address

6809 Mayfield Rd
952
Mayfield HTS, OH 44124-2266
Phone (440) 442-0743

Other identifiers 1

IdentifierTypeStateIssuer
IP#2432424MedicaidOH

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

LicenseStateTypeSpecialty
PN108513OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033210992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 MAYFIELD RD",
            "address_2": "952",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242266",
            "telephone_number": "440-442-0743",
            "fax_number": "440-442-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6809 MAYFIELD RD",
            "address_2": "952",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242266",
            "telephone_number": "440-442-0743",
            "fax_number": "440-442-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "BEN",
        "middle_name": "BONNIE",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN108513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IP#2432424",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.