Robert Benner PT PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT543 Issued in ME

Legal business name

ROBERT BENNER PT PA

Practice address

895 Kennedy Memorial Dr
Unit 3
Oakland, ME 04963-4874

Phone

(207) 465-4601

Fax

(207) 465-4602

NPI assigned

Nov 9, 2012

Organization subpart

No

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

Authorized official

Name

Robert C Benner, PT

Title

Owner

Phone

(207) 465-4601

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1467706655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1744",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049031744",
            "telephone_number": "207-465-4601",
            "fax_number": "207-465-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 KENNEDY MEMORIAL DR",
            "address_2": "UNIT 3",
            "city": "OAKLAND",
            "state": "ME",
            "postal_code": "049634874",
            "telephone_number": "207-465-4601",
            "fax_number": "207-465-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT BENNER PT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "BENNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-465-4601",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Oakland, ME
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• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.