Melissa Y Benton, PA-C
Individual provider Active NPI Physician Assistant · Harriman, TN
NPI 1477834604 · NPPES record last updated Sep 2, 2011
Key facts
- NPI
- 1477834604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1999 (TN)
- Practice address
- 412 Devonia St
Harriman, TN 37748-2009 - Phone
- (865) 882-4112
- NPI assigned
- Sep 1, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111207000506 | TN | Practitioner - Physician Assistant | 0547435216 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1999 | TN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spring Creek Emergency Physicians PLLC | Past | Accepting new patients | |
| Parkridge Medical Center, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1999 | TN | Yes |
Addresses
Primary practice location
412 Devonia St
Harriman, TN 37748-2009
Mailing address
1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984
Phone (865) 985-7209
Other providers in Harriman, TN
- Jennifer H Beets
- John Conard Belitz IV
- Christina Lenore Bell
- Bennett Services, LLC
- Meridith L. Benthal
- Terry Marshall Bingham
- Bio-Medical Applications of Tennessee, Inc.
- William J Black
- Dawn E Blaylock
- Harry G. Boye, Jr.
All providers in Harriman, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.