Active NPI
Carmel S Benbow, P.T.
- Physical Therapist
- Woodland, CA
National Provider Identifier
1477565000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT20687
- Practice address
- 475 Pioneer Ave
Suite 200
Woodland, CA 95776-4905 - Phone
- (530) 406-5620
- Fax
- (530) 406-5622
- NPI assigned
- Aug 12, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT20687 | CA | Primary |
Addresses
Primary practice location
475 Pioneer Ave
Suite 200
Woodland, CA 95776-4905
Mailing address
10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (855) 771-0335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT0206870 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2800 L St
Sacramento, CA 95816-5616
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT20687 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Medical Foundation | Physical Therapist | Current | Accepting new patients |
| Sutter Valley Medical Foundation | Current | Accepting new patients |
Locations
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
-
- Multi-Specialty Clinic/Center
- Fairfield, CA
- NPI 1184859894
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436400000000",
"number": "1477565000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 OLD PLACERVILLE RD",
"address_2": "SUITE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958272539",
"telephone_number": "855-771-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 PIONEER AVE",
"address_2": "SUITE 200",
"city": "WOODLAND",
"state": "CA",
"postal_code": "957764905",
"telephone_number": "530-406-5620",
"fax_number": "530-406-5622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENBOW",
"first_name": "CARMEL",
"middle_name": "S",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-12",
"last_updated": "2015-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT20687",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PT0206870",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.