Individual provider Active NPI

Deborah Ann Beneby

  • Audiologist
  • Port Charlotte, FL
National Provider Identifier
1043472095
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY1550 Issued in FL
Practice address
1900 Tamiami TRL
Suite 109
Port Charlotte, FL 33948-2180
Phone
(941) 743-5211
Fax
(941) 743-6380
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY1550 FL Primary

Addresses

Primary practice location

1900 Tamiami TRL
Suite 109
Port Charlotte, FL 33948-2180

Mailing address

P.O.Box 406153
Atlanta, GA 30384-1876
Phone (561) 478-8770

Other identifiers 1

IdentifierTypeStateIssuer
001298800MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY1550FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearusa Inc Past Accepting new patients
Hearusa Inc Past Accepting new patients
Audiology Distribution, LLC PastSince Apr 1, 2012 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1043472095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 406153",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841876",
            "telephone_number": "561-478-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TAMIAMI TRL",
            "address_2": "SUITE 109",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482180",
            "telephone_number": "941-743-5211",
            "fax_number": "941-743-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEBY",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001298800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.