Active NPI
Benjamin Murry
- Social Worker
- Rockford, IL
National Provider Identifier
1356790893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150101541
- Practice address
- 1021 N Mulford Rd
Rockford, IL 61107-3877 - Phone
- (815) 391-1000
- NPI assigned
- Jun 6, 2016
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 150101541 | IL | Primary |
Addresses
Primary practice location
1021 N Mulford Rd
Rockford, IL 61107-3877
Mailing address
1933 Douglas St Apt 1N
Rockford, IL 61103-4729
Phone (815) 721-9480
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 |
|---|---|---|---|
| 150101541 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465171200000",
"number": "1356790893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1933 DOUGLAS ST APT 1N",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611034729",
"telephone_number": "815-721-9480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 N MULFORD RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611073877",
"telephone_number": "815-391-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURRY",
"first_name": "BENJAMIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-06",
"last_updated": "2016-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150101541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.