Maggie Ruth Benham, DC
Individual provider Active NPI Chiropractor · Canandaigua, NY
NPI 1104164060 · NPPES record last updated May 27, 2015
Key facts
- NPI
- 1104164060
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- X012305-1 (NY)
- Practice address
- 23 Coach St
Canandaigua, NY 14424-1529 - Phone
- (585) 394-2030
- Fax
- (585) 394-0454
- NPI assigned
- Jan 27, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150624000268 | NY | Practitioner - Chiropractic | 7517278112 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X012305-1 | NY | MD | Chiropractor |
| 012305 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chosen Spot Chiropractic & Wellness PLLC | Chiropractor | Current |
Accepting new patients |
Locations
142 Bemis St
Canandaigua, NY 14424
Phone (585) 394-2030
23 Coach St
Ste 2B
Canandaigua, NY 14424
Phone (585) 394-2030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X012305-1 | NY | Yes |
Addresses
Primary practice location
23 Coach St
Canandaigua, NY 14424-1529
Mailing address
5216 E Lake Rd
Rushville, NY 14544-9751
Phone (585) 781-4101
Other providers in Canandaigua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2015. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.