Individual provider Active NPI

Clifford R Benson, DC

  • Chiropractor
  • Carriere, MS
National Provider Identifier
1114047594
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05820 Issued in KS
Practice address
6682 Highway 11 Ste 103
Carriere, MS 39426-7992
Phone
(601) 749-4939
Fax
(769) 301-1641
NPI assigned
Mar 30, 2007
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Chiropractor 111N00000X 01-05820 KS Primary

Addresses

Primary practice location

6682 Highway 11 Ste 103
Carriere, MS 39426-7992

Mailing address

PO Box 326
Picayune, MS 39466-0326
Phone (601) 749-4939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180824001518 MS Practitioner - Chiropractic 4789933797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6682 Hwy 11
Suite 103
Carriere, MS 39426-7992
Phone (601) 749-4939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05820KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
D. L. Moore & Associates, Inc Chiropractor CurrentSince Apr 30, 2023 Accepting new patients
D. L. Moore & Associates, Inc Chiropractor CurrentSince May 11, 2023 Accepting new patients
Moore Chiropractic Clinic Hattiesburg PLLC Chiropractor CurrentSince May 11, 2023 Accepting new patients
Dodson Chiropractic Chiropractor PastSince Jul 1, 2022 Accepting new patients

Locations

6682 Highway 11
Ste 103
Carriere, MS 39426
Phone (601) 749-4939

2737 Oak Grove Rd
Hattiesburg, MS 39402
Phone (601) 336-7253

Networks

  • LA PPO C-SNP

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1114047594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394660326",
            "telephone_number": "601-749-4939",
            "fax_number": "769-301-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6682 HIGHWAY 11 STE 103",
            "city": "CARRIERE",
            "state": "MS",
            "postal_code": "394267992",
            "telephone_number": "601-749-4939",
            "fax_number": "769-301-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "CLIFFORD",
        "middle_name": "R",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carriere, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.