Individual provider Active NPI

James Edward Benninger II, PHARM D.

  • Pharmacist
  • Mesa, AZ
National Provider Identifier
1265763114
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
016233 Issued in AZ
Practice address
2811 E Broadway Rd
Mesa, AZ 85204-1702
Phone
(480) 830-8752
Fax
(480) 830-0331
NPI assigned
Jan 15, 2010
Last updated
Jan 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 016233 AZ Primary

Addresses

Primary practice location

2811 E Broadway Rd
Mesa, AZ 85204-1702

Mailing address

2811 E Broadway Rd
Mesa, AZ 85204-1702
Phone (480) 830-8752

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
016233AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1265763114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 E BROADWAY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041702",
            "telephone_number": "480-830-8752",
            "fax_number": "480-830-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 E BROADWAY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041702",
            "telephone_number": "480-830-8752",
            "fax_number": "480-830-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNINGER",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "016233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.