Individual provider Active NPI

David Allen Benevento, D.C.

  • Chiropractor
  • Folsom, CA
National Provider Identifier
1508859182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
14310 Issued in CA
Practice address
2545 E Bidwell St
Suite 130
Folsom, CA 95630-6440
Phone
(916) 983-7664
NPI assigned
Aug 29, 2005
Reactivated
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 14310 CA Primary

Addresses

Primary practice location

2545 E Bidwell St
Suite 130
Folsom, CA 95630-6440

Mailing address

2545 E Bidwell St
Suite 130
Folsom, CA 95630-6440
Phone (916) 983-7664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109000653 CA Practitioner - Chiropractic 7911920608 Practice locations: Folsom, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2545 E Bidwell St
Suite 130
Folsom, CA 95630-6443
Phone (916) 983-7664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14310CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508859182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E BIDWELL ST",
            "address_2": "SUITE 130",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306440",
            "telephone_number": "916-983-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 E BIDWELL ST",
            "address_2": "SUITE 130",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306440",
            "telephone_number": "916-983-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEVENTO",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-04-18",
        "reactivation_date": "2006-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "14310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.