Amanda Benson, L.AC., M.C.M.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

2016 Issued in MN

Practice address

11500 Highway 7 Ste 204
Minnetonka, MN 55305-5107

Phone

(763) 222-8337

NPI assigned

Oct 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1457068371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 PINEVIEW LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554415768",
            "telephone_number": "763-222-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 HIGHWAY 7 STE 204",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055107",
            "telephone_number": "763-222-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "AMANDA",
        "credential": "L.AC., M.C.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "2016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA STATE LICENSE  NUMBER",
            "identifier": "2016",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbenson@imbuewellnessacu.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11500 Highway 7 Ste 204",
            "city": "Minnetonka",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553055107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dayton Dylan Bender
• Prachi Satish Bengeri, MS-CCC-SLP
• Anna M Bennett, CST
• Jennifer Bennett, M.S., L.P.
• Jennifer L. Bennett, MD
• Bradford B Benson, LISCW
• Burton Allan Benson Jr., MD
• Etoshia Rene Benson, APRN-C
• Kristin Ann Benson, MD
• Simone Natasha Bentley, APRN

• Acupuncturist in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.