Active NPI
Marilee Benson, MD
- Pediatric Radiology Physician
- Louisville, KY
National Provider Identifier
1053409508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Radiology Physician
- License
- 24378
- Practice address
- 231 E Chestnut St
Louisville, KY 40202-1821 - Phone
- (502) 629-7661
- Fax
- (502) 629-5309
- NPI assigned
- Oct 10, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Radiology Physician | 2085P0229X | 24378 | KY | Primary |
Addresses
Primary practice location
231 E Chestnut St
Louisville, KY 40202-1821
Mailing address
PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200221540 | Medicaid | IN | |
| 64243785 | Medicaid | KY | |
| 000000545160 | Other | KY | ANTHEM FOR KCR |
| 000023029O | Other | KY | HUMANA - KCR |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24378 | KY | MD | Pediatric Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Radiology Associates, PSC | Pediatric Radiology | Past | Accepting new patients |
| Diagnostic Imaging Alliance of Louisville PSC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Louisville, KY
- NPI 1396765509
-
- Pediatric Radiology Physician
- Louisville, KY
- NPI 1225138092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572307200000",
"number": "1053409508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776351",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776351",
"telephone_number": "502-588-9490",
"fax_number": "502-272-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 E CHESTNUT ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021821",
"telephone_number": "502-629-7661",
"fax_number": "502-629-5309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "MARILEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2019-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "KY",
"license": "24378",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200221540",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64243785",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM FOR KCR",
"identifier": "000000545160",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA - KCR",
"identifier": "000023029O",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.