Individual provider Active NPI

Brent Whitcombe Benson, D.C.

  • Chiropractor
  • Cody, WY
National Provider Identifier
1508919507
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
600 Issued in WY
Practice address
931 13TH St
Cody, WY 82414-3603
Phone
(307) 587-1234
Fax
(307) 587-4311
NPI assigned
Jan 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 600 WY Primary

Addresses

Primary practice location

931 13TH St
Cody, WY 82414-3603

Mailing address

931 13TH St
Cody, WY 82414-3603
Phone (307) 587-1234

Other identifiers 1

IdentifierTypeStateIssuer
314146OtherWYBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060411000112 WY Practitioner - Chiropractic 6204845845 Practice locations: Cody, WY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

902 Blackburn St
Suite D
Cody, WY 82414-8494
Phone (307) 587-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
600WYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chinook Chiropractic, LLC Chiropractor Current Accepting new patients
Vincent Kalkowski DC PC Chiropractor PastSince Jul 1, 2001 Accepting new patients

Locations

902 Blackburn St
Ste D
Cody, WY 82414
Phone (307) 587-1234

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508919507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 13TH ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143603",
            "telephone_number": "307-587-1234",
            "fax_number": "307-587-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 13TH ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143603",
            "telephone_number": "307-587-1234",
            "fax_number": "307-587-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "BRENT",
        "middle_name": "WHITCOMBE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "314146",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

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.