Active NPI
Benadette Song
- Psychiatric/Mental Health Nurse Practitioner
- Richmond, IN
National Provider Identifier
1063360030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 71017857A
- Practice address
- 1130 N J St
Richmond, IN 47374-1913 - Phone
- (765) 983-7970
- NPI assigned
- Mar 17, 2026
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71017857A | IN | Primary |
Addresses
Primary practice location
1130 N J St
Richmond, IN 47374-1913
Mailing address
1100 Reid Pkwy
Richmond, IN 47374-1157
Other practice location 1
1915 Chester Blvd
Richmond, IN 47374-1212
Phone (765) 983-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Indiana University School of Medicine, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1100 Reid Pkwy
Richmond, IN 47374-1157
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71017857A | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Richmond, IN
- NPI 1265689111
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789603200000",
"number": "1063360030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 REID PKWY",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473741157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 N J ST",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473741913",
"telephone_number": "765-983-7970"
}
],
"practiceLocations": [
{
"address_1": "1915 Chester Blvd",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "IN",
"postal_code": "473741212",
"country_code": "US",
"telephone_number": "765-983-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SONG",
"first_name": "BENADETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-17",
"last_updated": "2026-09-17",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IN",
"license": "71017857A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.