Kristine M Benda, NP
Individual provider Active NPI Pediatrics Physician · Alliance, NE
NPI 1083908511 · NPPES record last updated Apr 2, 2024
Key facts
- NPI
- 1083908511
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 113345 (NE)
- Practice address
- 2091 Box Butte Ave
Alliance, NE 69301-4452 - Phone
- (308) 762-7244
- NPI assigned
- Jun 1, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240605002344 | NE | Practitioner - Nurse Practitioner | 4688845316 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66913 | NE | MD | Registered Nurse |
| 113345 | NE | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Box Butte General Hospital | Current | Accepting new patients | |
| Community Health Center of the Black Hills, Inc | Past | Accepting new patients | |
| Box Butte General Hospital | Past | Accepting new patients |
Locations
2101 Box Butte Ave
Alliance, NE 69301
Phone (308) 762-6660
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 66913 | NE | |
| Pediatrics Physician | 208000000X | 113345 | NE | Yes |
Addresses
Primary practice location
2091 Box Butte Ave
Alliance, NE 69301-4452
Mailing address
2091 Box Butte Ave
Alliance, NE 69301-4452
Phone (308) 762-7244
Other providers in Alliance, NE
- Kimberly Marie Bauer
- Nicole Bauer
- Rylan Lee Bauer
- Tammie Beal
- Siminda Jo Belford
- Ivy Bennett
- Kayla Lauren Beshears
- Amanda B Best
- Bette J Odell MSW Services LLC
- Tammy Bettencourt
All providers in Alliance, NE · Pediatrics Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.