Active NPI
Benjamin T Stefka, ATC
- Athletic Trainer
- Fort Worth, TX
National Provider Identifier
1386258341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- BOC198225
- Practice address
- 9936 Gessner Dr
Fort Worth, TX 76244-5085 - Phone
- (469) 766-5876
- NPI assigned
- Sep 6, 2020
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | BOC198225 | TX | Primary |
Addresses
Primary practice location
9936 Gessner Dr
Fort Worth, TX 76244-5085
Mailing address
9936 Gessner Dr
Fort Worth, TX 76244-5085
Phone (469) 766-5876
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 |
|---|---|---|---|
| BOC198225 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599350400000",
"number": "1386258341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9936 GESSNER DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762445085",
"telephone_number": "469-766-5876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9936 GESSNER DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762445085",
"telephone_number": "469-766-5876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEFKA",
"first_name": "BENJAMIN",
"middle_name": "T",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-06",
"last_updated": "2020-09-06",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "BOC198225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.