Individual provider Active NPI

Benjamin Clarence Groves, MD

  • Neurology Physician
  • Fort Myers, FL
National Provider Identifier
1396242202
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME157350 Issued in FL
Practice address
11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206
Phone
(239) 208-2212
NPI assigned
Apr 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 35.146709 OH
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X ME157350 FL Primary
Neurology Physician 2084N0400X 66978 TN
Neurology Physician 2084N0400X 2022043471 MO

Addresses

Primary practice location

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206

Mailing address

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206
Phone (239) 208-2212

Other practice location 1

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

Other practice location 2

630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2000

Other practice location 3

2790 Clay Edwards Dr Ste 1235
North Kansas City, MO 64116-3276
Phone (816) 472-5157

Other practice location 4

1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone (931) 783-5223

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Direct Messaging Address bgroves862539@direct.ketteringhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, SC, TN, NY, WA, OR7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20220808000143 FL Practitioner - Neurology 7012399033 Reassigns benefits to 1 organization
I20220927002120 GA Practitioner - Neurology 7012399033 Reassigns benefits to 4 organizations
I20221018003697 SC Practitioner - Neurology 7012399033
I20230428001265 TN Practitioner - Neurology 7012399033 Reassigns benefits to 3 organizations
I20230525000248 NY Practitioner - Neurology 7012399033 Reassigns benefits to 5 organizations
I20230907002521 WA Practitioner - Neurology 7012399033 Reassigns benefits to 1 organization
I20230908001184 OR Practitioner - Neurology 7012399033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
East Tennessee State University Quillen College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cookeville Regional Medical CenterGroup PAC ID 7810805736, 51 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 783-2497

Hospital & facility affiliations

  • Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.146709OHMDNeurology Physician
66978TNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Silverton Health Family Medicine CurrentSince Aug 24, 2023 Accepting new patients
Lee Memorial Health System CurrentSince Jun 6, 2023 Accepting new patients
Piedmont Athens Hospitalist Physicians LLC CurrentSince Feb 13, 2023 Accepting new patients
St Charles Hospital Corp CurrentSince Apr 17, 2023 Accepting new patients
Silverton Health Family Medicine CurrentSince Aug 24, 2023 Accepting new patients
Cookeville Regional Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Mercy Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Virtual Neurology New Jersey LLC Neurology CurrentSince Feb 28, 2024 Accepting new patients
St. Catherine of Siena Medical Center CurrentSince Apr 17, 2023 Accepting new patients
Upson County Hospital Inc Family Medicine CurrentSince Aug 20, 2022 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Family Medicine CurrentSince Feb 13, 2023 Accepting new patients
St. Joseph Hospital CurrentSince Apr 17, 2023 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Aug 24, 2023 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Family Medicine CurrentSince Feb 13, 2023 Accepting new patients
Cookeville Regional Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Silverton Health Current Accepting new patients
Lee Memorial Health System Family Medicine CurrentSince Jun 6, 2023 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Aug 24, 2023 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Apr 17, 2023 Accepting new patients
Mercy Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Upson County Hospital Inc Neurology CurrentSince Aug 20, 2022 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Aug 24, 2023 Accepting new patients
Piedmont Hospitalist Physicians LLC Family Medicine CurrentSince Feb 13, 2023 Accepting new patients
Piedmont Athens Specialty Care LLC Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

11215 Metro Pkwy
Ste 100
Fort Myers, FL 33966
Phone (239) 208-2206

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

11215 Metro Pkwy
Ste 1
Fort Myers, FL 33966
Phone (239) 208-2206

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 29

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

View all 29

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1396242202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Erwin Rd",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277054699",
            "country_code": "US",
            "telephone_number": "919-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 Eaton Ave",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450132767",
            "country_code": "US",
            "telephone_number": "513-867-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2790 Clay Edwards Dr Ste 1235",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163276",
            "country_code": "US",
            "telephone_number": "816-472-5157",
            "fax_number": "816-472-7201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014294",
            "country_code": "US",
            "telephone_number": "931-783-5223",
            "fax_number": "931-783-5123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVES",
        "first_name": "BENJAMIN",
        "middle_name": "CLARENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-07",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35.146709",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME157350",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "66978",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2022043471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgroves862539@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.