Individual provider Active NPI

Jennifer Deann Benton, NP

  • Family Nurse Practitioner
  • Morehead City, NC
National Provider Identifier
1164748638
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200837 Issued in NC
Practice address
810 Arendell St
Morehead City, NC 28557-4235
Phone
(252) 499-9598
NPI assigned
Apr 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200837 NC Primary

Addresses

Primary practice location

810 Arendell St
Morehead City, NC 28557-4235

Mailing address

PO Box 3387
Morganton, NC 28680-3387
Phone (828) 584-1105

Other identifiers 2

IdentifierTypeStateIssuer
7004929MedicaidNC
6113151MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200837NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fayetteville Area Health Education Foundation Inc CurrentSince Apr 30, 2017 Accepting new patients
Southmountain Children and Family Services CurrentSince Apr 16, 2023 Accepting new patients
Southmountain Children and Family Services PastSince Apr 16, 2023 Accepting new patients
Southmountain Children and Family Services PastSince Feb 2, 2020 Accepting new patients

Locations

1601 Owen Dr
Fayetteville, NC 28304
Phone (910) 323-1152

810 Arendell St
Morehead City, NC 28557
Phone (252) 499-9598

Interoperability endpoints

  • Direct secure messaging: jbenton@opakidz.opdirect.net

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": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1164748638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3387",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286803387",
            "telephone_number": "828-584-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 ARENDELL ST",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574235",
            "telephone_number": "252-499-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "JENNIFER",
        "middle_name": "DEANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-08",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "200837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004929",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6113151",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.