Jodi Benham, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1218376TX Issued in TX

Practice address

6202 82ND St
Lubbock, TX 79424-3691

Phone

(806) 687-8008

Fax

(806) 687-8009

NPI assigned

Jul 18, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1033464748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 S LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231519",
            "telephone_number": "806-771-7661",
            "fax_number": "806-687-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6202 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243691",
            "telephone_number": "806-687-8008",
            "fax_number": "806-687-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENHAM",
        "first_name": "JODI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "PT1218376TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "540040100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "877T26",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01108473",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370335502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307335501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ben Edwards PA
• Marqui Lynelle Benavides, RDN, LD
• Natalie Shumway Benavides
• Gustavo Alonso Bendeck, PA
• William Bret Benge
• Benjamin J. Williams MD, PHD, PA
• Juthipong Benjanuwattra, MD
• Ashlynn Mackenzie Bennett
• Justin Bennett, LCSW
• Kelly A. Bennett, M.D.

• Physical Therapist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.