Individual provider Active NPI

Benjamin Lee Storie, RN

  • Registered Nurse
  • Jacksonville, FL
National Provider Identifier
1104112473
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9226274 Issued in FL
Practice address
12236 Rochford LN
Jacksonville, FL 32225-4730
Phone
(904) 891-0076
Fax
(904) 642-7429
NPI assigned
Jun 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9226274 FL Primary

Addresses

Primary practice location

12236 Rochford LN
Jacksonville, FL 32225-4730

Mailing address

12236 Rochford LN
Jacksonville, FL 32225-4730
Phone (904) 891-0076

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9226274FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1104112473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12236 ROCHFORD LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322254730",
            "telephone_number": "904-891-0076",
            "fax_number": "904-642-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12236 ROCHFORD LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322254730",
            "telephone_number": "904-891-0076",
            "fax_number": "904-642-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORIE",
        "first_name": "BENJAMIN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9226274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.