NPIMap

Organization Active NPI

Bloomsburg Physicians Services

Doing business as BPS Benton Family Practice

  • Family Medicine Physician
  • Benton, PA
National Provider Identifier
1285967208
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BLOOMSBURG PHYSICIANS SERVICES
Doing business as
BPS Benton Family Practice
Practice address
4469 Red Rock Rd
Benton, PA 17814-7606
Phone
(570) 925-6424
NPI assigned
Sep 9, 2009
Last updated
Sep 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Authorized official

Name
Mr. Regis Cabonor
Title
Ceo
Phone
(570) 387-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4469 Red Rock Rd
Benton, PA 17814-7606

Mailing address

PO Box 919
Bloomsburg, PA 17815-0919
Phone (570) 387-2100

Other identifiers 1

IdentifierTypeStateIssuer
001811559MedicaidPA

Other names 1

  • BPS BENTON FAMILY PRACTICE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bloomsburg Physicians Services14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1285967208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178150919",
            "telephone_number": "570-387-2100",
            "fax_number": "570-387-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4469 RED ROCK RD",
            "city": "BENTON",
            "state": "PA",
            "postal_code": "178147606",
            "telephone_number": "570-925-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMSBURG PHYSICIANS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "CABONOR",
        "authorized_official_first_name": "REGIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-387-2100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001811559",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BPS BENTON FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.