Jonathan Benzing

Key facts

NPI

1164976320

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

13395-24 (WI)

Practice address

1650 S 41St St
Manitowoc, WI 54220-7316

Phone

(920) 320-3100

Fax

(920) 320-5114

NPI assigned

Aug 5, 2016

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 5, 2016.

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1164976320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WESTERN AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203712",
            "telephone_number": "920-320-3100",
            "fax_number": "920-320-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316",
            "telephone_number": "920-320-3100",
            "fax_number": "920-320-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENZING",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13395-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700998697",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

• Bellin Memorial Hospital Inc
• Bellin Memorial Hospital Inc
• Bellin Memorial Hospital Inc
• Bellin Memorial Hospital Inc. Dba FMC Manitowoc
• Bellin Psychiatric Center Inc
• Jennifer L Benzinger, LPN
• Karen A Berge, LCSW
• Emily Jean Bernhardt, MSW APSW
• Joseph M Bernhart
• William John Bero, DDS

All providers in Manitowoc, WI · Physical Therapist in Wisconsin