NPIMap

Individual provider Active NPI

Benjamin L Harrell, MD

  • Family Medicine Physician
  • Whigham, GA
National Provider Identifier
1104812361
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
101257079 Issued in VA
Practice address
458 Newberry Rd
Whigham, GA 39897-2924
Phone
(404) 537-2221
NPI assigned
Sep 23, 2005
Last updated
Dec 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 050525 GA
Family Medicine Physician 207Q00000X 101257079 VA Primary

Addresses

Primary practice location

458 Newberry Rd
Whigham, GA 39897-2924

Mailing address

458 Newberry Rd
Whigham, GA 39897-2924
Phone (404) 537-2221

Other identifiers 2

IdentifierTypeStateIssuer
00922215EMedicaidGA
000922215FMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
101257079VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Medical Group, Inc Past Accepting new patients
Chestatee Emergency Physicians, LLC Past Accepting new patients
Floyd Healthcare Management Inc Past Accepting new patients
Foothills Family Medicine Inc Family Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9034/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1104812361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 NEWBERRY RD",
            "city": "WHIGHAM",
            "state": "GA",
            "postal_code": "398972924",
            "telephone_number": "404-537-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 NEWBERRY RD",
            "city": "WHIGHAM",
            "state": "GA",
            "postal_code": "398972924",
            "telephone_number": "404-537-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "BENJAMIN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "050525",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "101257079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00922215E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000922215F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whigham, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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.