Individual provider Active NPI

Eddie T. Benion Jr., ATC

  • Athletic Trainer
  • Cleveland, OH
National Provider Identifier
1306058847
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-002442 Issued in OH
Practice address
2000 Prospect Avenue
Cleveland, OH 44115
Phone
(216) 687-5287
Fax
(216) 687-9355
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT-002442 OH Primary

Addresses

Primary practice location

2000 Prospect Avenue
Cleveland, OH 44115

Mailing address

2000 Prospect Avenue
Cleveland, OH 44115
Phone (216) 687-5287

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

LicenseStateTypeSpecialty
AT-002442OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306058847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PROSPECT AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44115",
            "telephone_number": "216-687-5287",
            "fax_number": "216-687-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PROSPECT AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44115",
            "telephone_number": "216-687-5287",
            "fax_number": "216-687-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENION",
        "first_name": "EDDIE",
        "middle_name": "T.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT-002442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.