Individual provider Active NPI

Benjamin Hart, CNM

  • Advanced Practice Midwife
  • Duluth, MN
National Provider Identifier
1528470655
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
368 Issued in MN
Practice address
1000 E 1St St Ste LL
Duluth, MN 55805
Phone
(218) 249-4700
Fax
(218) 722-5148
NPI assigned
May 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN623978 PA
Advanced Practice Midwife 367A00000X MW010341 PA
Advanced Practice Midwife 367A00000X 368 MN Primary

Addresses

Primary practice location

1000 E 1St St Ste LL
Duluth, MN 55805

Mailing address

1000 E 1St St Ste LL
Duluth, MN 55805-2297
Phone (218) 249-4700

Other practice location 1

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 772-1000

Other practice location 2

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 772-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140904000118 TX Practitioner - Certified Nurse Midwife (CNM) 0244458263 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN623978PAMDRegistered Nurse
368MNMDAdvanced Practice Midwife
MW010341PAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jun 29, 2014 Accepting new patients
Thoreau Clinic CurrentSince Sep 8, 2015 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Mar 31, 2016 Accepting new patients
DHHS PHS Naihs Crownpoint Hospital CurrentSince Sep 8, 2015 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Mar 31, 2016 Accepting new patients
Pueblo Pintado Clinic Current Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 6

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": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1528470655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST STE LL",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-249-4700",
            "fax_number": "218-722-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST STE LL",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-249-4700",
            "fax_number": "218-722-5148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 E Nizhoni Blvd",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873015748",
            "country_code": "US",
            "telephone_number": "505-772-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "516 E Nizhoni Blvd",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873015748",
            "country_code": "US",
            "telephone_number": "505-772-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART",
        "first_name": "BENJAMIN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN623978",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010341",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.