Active NPI
Kevin F Benson, D.C.
- Sports Physician Chiropractor
- Rockville, MD
National Provider Identifier
1265558217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 01875
- Practice address
- 6211 Executive Blvd
Rockville, MD 20852-3906 - Phone
- (301) 231-5600
- Fax
- (301) 231-8640
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 01875 | MD | Primary |
Addresses
Primary practice location
6211 Executive Blvd
Rockville, MD 20852-3906
Mailing address
19333 Churubusco LN
Germantown, MD 20874-1572
Phone (301) 540-8457
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01875 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1265558217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19333 CHURUBUSCO LN",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208741572",
"telephone_number": "301-540-8457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6211 EXECUTIVE BLVD",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208523906",
"telephone_number": "301-231-5600",
"fax_number": "301-231-8640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "KEVIN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "MD",
"license": "01875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.