Individual provider Active NPI

Samuel Joseph Benson

  • Flight Registered Nurse
  • Robbinsdale, MN
National Provider Identifier
1508647371
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Flight Registered NurseTaxonomy code 163WF0300X
License
2461500 Issued in MN
Practice address
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone
(763) 520-5200
NPI assigned
Oct 9, 2023
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Flight Registered Nurse 163WF0300X 2461500 MN Primary

Addresses

Primary practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Mailing address

13242 Spencer Sweet Pea LN
Eden Prairie, MN 55347-2182
Phone (605) 254-8927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2461500MNMDFlight Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1508647371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13242 SPENCER SWEET PEA LN",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553472182",
            "telephone_number": "605-254-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-520-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WF0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Flight",
            "state": "MN",
            "license": "2461500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.