Jean Lazenby Benton, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

200956 Issued in NC

Practice address

111 E Third Ave
Gastonia, NC 28052-4343

Phone

(704) 874-3300

Fax

(704) 874-0065

NPI assigned

Jun 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beatrice Lazenby Denton Other name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 29)

Interoperability endpoints

• Direct secure messaging: jbenton249177@direct.ochin.org

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.

• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1215932215

  NC

  Medicare reassignment NPD
• Gaston Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1467458588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904",
            "fax_number": "704-867-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E THIRD AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524343",
            "telephone_number": "704-874-3300",
            "fax_number": "704-874-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "JEAN",
        "middle_name": "LAZENBY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "200956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000985",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEATRICE",
            "last_name": "DENTON",
            "middle_name": "LAZENBY",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yuri Benitez, MD
• Lutricia Freeman Bennett, FNP
• Janet Hoffman Benoy, LMBT, MMP, CPMT
• Melissa Kelly Benson, LCSW, LCAS
• Karen B Bentley, M.D.
• Mitchel Benton
• Jennifer S. Beretsky, NP-C
• Kelly Marie Bergen, NP
• Nidia M Bermudez, MSW, LCSWA
• Vakesia Berrios, RN

• All providers in Gastonia, NC
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.