Active NPI
Benefield Eye Care, PC
- Specialist
- Gulfport, MS
National Provider Identifier
1104879196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 012410
- Legal business name
- BENEFIELD EYE CARE, PC
- Practice address
- 11240 Highway 49
Ste 300
Gulfport, MS 39503-4151 - Phone
- (228) 328-0972
- Fax
- (228) 328-0975
- NPI assigned
- May 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donald W Benefield, MD
- Title
- President
- Phone
- (228) 328-0972
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 012410 | MS | Primary |
Addresses
Primary practice location
11240 Highway 49
Ste 300
Gulfport, MS 39503-4151
Mailing address
11240 Highway 49
Ste 300
Gulfport, MS 39503-4151
Phone (228) 328-0972
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09016235 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050729000353 | MS | Part B Supplier - Clinic/Group Practice | 0143258368 |
Receives reassigned benefits from 4 practitioners Practice locations: Gulfport, MS |
National Provider Directory
National Provider DirectoryLocations
14225 Dedeaux Rd
Gulfport, MS 39503
Phone (228) 328-0972
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1204848000000",
"number": "1104879196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11240 HIGHWAY 49",
"address_2": "STE 300",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395034151",
"telephone_number": "228-328-0972",
"fax_number": "228-328-0975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11240 HIGHWAY 49",
"address_2": "STE 300",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395034151",
"telephone_number": "228-328-0972",
"fax_number": "228-328-0975"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BENEFIELD EYE CARE, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2008-03-07",
"status": "A",
"authorized_official_last_name": "BENEFIELD",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "228-328-0972",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "MS",
"license": "012410",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09016235",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.