Individual provider Active NPI

Cheri Denise Benner

  • Pediatrics Physician
  • Three Rivers, MI
National Provider Identifier
1316408313
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101027580 Issued in MI
Practice address
601 S US Highway 131
Three Rivers, MI 49093-8831
Phone
(269) 286-7070
NPI assigned
Mar 31, 2019
Last updated
Jun 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4868 TN
Pediatrics Physician 208000000X 5101027580 MI Primary

Addresses

Primary practice location

601 S US Highway 131
Three Rivers, MI 49093-8831

Mailing address

601 S US Highway 131
Three Rivers, MI 49093-8831

Other practice location 1

848 Adams Ave
Memphis, TN 38103-2816
Phone (301) 785-8767

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson HealthCare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222001741 MI Practitioner - Pediatric Medicine 9638402662 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4868TNMDObstetrics & Gynecology Physician
5101027580MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Mar 25, 2024 Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 S US Highway 131
Three Rivers, MI 49093
Phone (269) 286-7070

Interoperability endpoints

  • Direct secure messaging: cbenner23781@mlh.direct-ci.com
  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1316408313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S US HIGHWAY 131",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S US HIGHWAY 131",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938831",
            "telephone_number": "269-286-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "848 Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032816",
            "country_code": "US",
            "telephone_number": "301-785-8767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNER",
        "first_name": "CHERI",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-31",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "4868",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101027580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson HealthCare Group Direct Address",
            "affiliationName": "Bronson HealthCare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

Verify at the official NPI Registry.