Individual provider Active NPI

Beverly Paige Bennion

  • Homemaker
  • Boise, ID
National Provider Identifier
1144470493
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
Practice address
4980 W State St Ste a
Boise, ID 83703-3326
Phone
(208) 639-1649
Fax
(208) 639-0813
NPI assigned
Sep 23, 2008
Last updated
Oct 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X NU
Adult Companion 372600000X ID
Personal Care Attendant 3747P1801X ID
Homemaker 376J00000X ID Primary

Addresses

Primary practice location

4980 W State St Ste a
Boise, ID 83703-3326

Mailing address

2055 Garrett Way
Ste 1
Pocatello, ID 83201-5100
Phone (208) 236-1600

Other identifiers 1

IdentifierTypeStateIssuer
1144470493MedicaidID

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
J and E Services, LLC Past Accepting new patients

Organizations & group practices 1

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1144470493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 GARRETT WAY",
            "address_2": "STE 1",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015100",
            "telephone_number": "208-236-1600",
            "fax_number": "208-236-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 W STATE ST STE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033326",
            "telephone_number": "208-639-1649",
            "fax_number": "208-639-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNION",
        "first_name": "BEVERLY",
        "middle_name": "PAIGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144470493",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.