Active NPI
Etoshia Rene Benson, APRN-C
- Family Nurse Practitioner
- Minnetonka, MN
National Provider Identifier
1538391875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3983
- Practice address
- 9900 Bren Rd E
Minnetonka, MN 55343-9664 - Phone
- (800) 458-5653
- NPI assigned
- Aug 20, 2009
- Last updated
- Aug 3, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3983 | SC | Primary |
Addresses
Primary practice location
9900 Bren Rd E
Minnetonka, MN 55343-9664
Mailing address
15 Glendale St
Greenville, SC 29605-3228
Phone (864) 423-8722
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP1535 | Other | SC | MCD# |
| NP1535 | Medicaid | SC |
Other names 1
- Etoshia Rene Rouse
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millstone Healthcare Associates, P.a. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Physician
- Greenville, SC
- NPI 1811934730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1538391875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 GLENDALE ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296053228",
"telephone_number": "864-423-8722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664",
"telephone_number": "800-458-5653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "ETOSHIA",
"middle_name": "RENE",
"name_prefix": "Ms.",
"credential": "APRN-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-20",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "3983",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCD#",
"identifier": "NP1535",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP1535",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ETOSHIA",
"last_name": "ROUSE",
"middle_name": "RENE",
"credential": "APRN-C",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.