Individual provider Active NPI

Benjamin Eric Grounds

  • Obstetrics & Gynecology Physician
  • Twentynine Palms, CA
National Provider Identifier
1104247444
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101259691 Issued in VA
Practice address
1145 Sturgis Road
Twentynine Palms, CA 92278-8275
Phone
(760) 830-2117
NPI assigned
Jan 3, 2014
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 0101259691 VA Primary

Addresses

Primary practice location

1145 Sturgis Road
Twentynine Palms, CA 92278-8275

Mailing address

1145 Sturgis Road
Twentynine Palms, CA 92278
Phone (760) 830-2117

Other practice location 1

620 John Paul Jones Cir
Naval medical Center Portsmouth
Portsmouth, VA 23708-2197
Phone (757) 953-0669

Other practice location 2

1 Administration Cir
Ridgecrest, CA 93555-6104
Phone (760) 939-8030

Other practice location 3

1145 Sturgis Road
Bridgeport, CA 93517-9802
Phone (760) 932-1616

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
0101259691VAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1104247444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 STURGIS ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92278",
            "telephone_number": "760-830-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 STURGIS ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922788275",
            "telephone_number": "760-830-2117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 John Paul Jones Cir",
            "address_2": "Naval medical Center Portsmouth",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082197",
            "country_code": "US",
            "telephone_number": "757-953-0669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Administration Cir",
            "address_purpose": "LOCATION",
            "city": "Ridgecrest",
            "state": "CA",
            "postal_code": "935556104",
            "country_code": "US",
            "telephone_number": "760-939-8030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1145 Sturgis Road",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CA",
            "postal_code": "935179802",
            "country_code": "US",
            "telephone_number": "760-932-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROUNDS",
        "first_name": "BENJAMIN",
        "middle_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-03",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101259691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twentynine Palms, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.