Kimberly Kay Benkner, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704386315 Issued in MI

Practice address

44201 Dequindre Rd Ste Ec
Troy, MI 48085-1117

Phone

(248) 259-3088

Fax

(248) 964-6133

NPI assigned

Jan 9, 2014

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965

  MI

  Medicare reassignment NPD
• Iha Health Service Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  • Urgent Care Clinic/Center
  • Ann Arbor, MI
  • NPI 1992937023
  NPD
• Iha Health Services Corporation

  • Family Medicine Physician
  • Milan, MI
  • NPI 1467509067
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbenkner1886636@direct.trinity-health.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 27, 2022.

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1104248129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD STE EC",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-259-3088",
            "fax_number": "248-964-6133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44199 Dequindre Rd Ste 502",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-964-5880",
            "fax_number": "248-964-5068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENKNER",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704386315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0111452",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbenkner4468452@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd Ste Ec",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benchmark Psychometrics
• Elizabeth Anne Benedetti-Weber, OTR/L
• Angela Jean Benefield
• Leigh Anne Benigni
• Molly Marie Benjamin, OTRL
• Emily Megan Bennett
• Jessica A Bennett, LPC
• Bensy Benoy
• Samaria Benson
• Halle Bentz

• All providers in Troy, MI
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.