Kelly Ann Benedict, M.D.

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

License

49162 Issued in AZ

Practice address

3333 E Camelback Rd
Ste 180
Phoenix, AZ 85018-2322

Phone

(602) 997-0484

Fax

(602) 224-3315

NPI assigned

Jul 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1841573870
  Medicare reassignment NPD
• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment NPD
• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1386462810
  NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1437482544
  NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Akdhc, LLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1205274735
  NPD (past)
• Akdhc, LLC

  • Nephrology Physician
  • Phoenix, AZ
  • NPI 1316902208
  NPD (past)

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1144429747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E THOMAS RD",
            "address_2": "STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167969",
            "telephone_number": "602-903-1532",
            "fax_number": "602-956-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD",
            "address_2": "STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182322",
            "telephone_number": "602-997-0484",
            "fax_number": "602-224-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "AZ",
            "license": "49162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "921982",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devin Allen Bender, RBT
• Jara Dee Bender, MSW, LCSW
• Joel Bender, PTA
• Paul Eugene Bendheim, M.D.
• Lucia Bendikova
• Nicole Benedict, MSOTR
• Benedicta House
• Benegent Health
• Gina Benetich
• Gina Benevento, LMSW

• Pediatric Nephrology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatric Nephrology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.