Individual provider Active NPI

Benedict B Benigno, M.D.

  • Gynecologic Oncology Physician
  • Atlanta, GA
National Provider Identifier
1205802733
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
017010 Issued in GA
Practice address
980 Johnson Fy Rd NE
Suite 130
Atlanta, GA 30342-1626
Phone
(404) 300-2990
Fax
(404) 300-2986
NPI assigned
Feb 24, 2006
Last updated
Jan 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 017010 GA Primary

Addresses

Primary practice location

980 Johnson Fy Rd NE
Suite 130
Atlanta, GA 30342-1626

Mailing address

980 Johnson Fy Rd NE
Suite 130
Atlanta, GA 30342-1626
Phone (404) 300-2990

Other identifiers 1

IdentifierTypeStateIssuer
000007246FMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017010GAMDGynecologic Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1205802733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE",
            "address_2": "SUITE 130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421626",
            "telephone_number": "404-300-2990",
            "fax_number": "404-300-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE",
            "address_2": "SUITE 130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421626",
            "telephone_number": "404-300-2990",
            "fax_number": "404-300-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENIGNO",
        "first_name": "BENEDICT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "GA",
            "license": "017010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000007246F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.