Individual provider Active NPI

Jennifer Louise Benton, D.C.

  • Chiropractor
  • Terre Haute, IN
National Provider Identifier
1164763876
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002917A Issued in IN
Practice address
3128 Poplar St
Terre Haute, IN 47803-2665
Phone
(812) 239-2244
Fax
(812) 232-7247
NPI assigned
Mar 5, 2013
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002917A IN Primary

Addresses

Primary practice location

3128 Poplar St
Terre Haute, IN 47803-2665

Mailing address

3128 Poplar St
Terre Haute, IN 47803-2665
Phone (812) 239-2244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130513000214 GA Practitioner - Chiropractic 4880831718 Reassigns benefits to 1 organization
I20160915000089 IN Practitioner - Chiropractic 4880831718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

324 S 25TH St
Terre Haute, IN 47803-2232
Phone (812) 239-2244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellman Family Healthcare Chiropractor CurrentSince Feb 21, 2013 Accepting new patients
Benton Family Healthcare LLC Chiropractor CurrentSince Aug 21, 2016 Accepting new patients
Simply Relief Chiropractic, LLC Chiropractor PastSince Jan 2, 2022 Accepting new patients

Locations

124 Chapel Crossing Rd
Brunswick, GA 31525
Phone (912) 554-2002

82 Buckingham Pl
Ste B
Brunswick, GA 31525
Phone (912) 554-2002

3128 Poplar St
Terre Haute, IN 47803
Phone (812) 232-3718

324 S 25th St
Terre Haute, IN 47803
Phone (812) 239-2244

4320 S 7th St
Terre Haute, IN 47802
Phone (812) 299-7000

Organizations & group practices 3

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": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1164763876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3128 POPLAR ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478032665",
            "telephone_number": "812-239-2244",
            "fax_number": "812-232-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3128 POPLAR ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478032665",
            "telephone_number": "812-239-2244",
            "fax_number": "812-232-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-05",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002917A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.