Individual provider Active NPI

Scott Kenneth Benson, AG-ACNPC

  • Nurse Practitioner
  • North Chesterfield, VA
National Provider Identifier
1083382717
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024181457 Issued in VA
Practice address
9460 Amderdale Drive, Suite E
North Chesterfield, VA 23236
Phone
(804) 533-0220
Fax
(804) 533-0230
NPI assigned
Aug 30, 2021
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024181457 VA Primary
Critical Care Medicine Nurse Practitioner 363LC0200X 0024181457 VA

Addresses

Primary practice location

9460 Amderdale Drive, Suite E
North Chesterfield, VA 23236

Mailing address

PO Box 402924
Atlanta, GA 30384-2924
Phone (804) 533-0220

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
0024181457VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Healthcare of Central Virginia Inc CurrentSince Oct 17, 2021 Accepting new patients

Locations

9460 Amberdale Dr
Ste E
North Chesterfield, VA 23236
Phone (804) 533-0220

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1083382717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402924",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842924",
            "telephone_number": "804-533-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 AMDERDALE DRIVE, SUITE E",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "23236",
            "telephone_number": "804-533-0220",
            "fax_number": "804-533-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "SCOTT",
        "middle_name": "KENNETH",
        "credential": "AG-ACNPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024181457",
            "primary": true
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "VA",
            "license": "0024181457",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.