Benjamin Withers

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2004033755 Issued in MO

Practice address

1230 N Duquesne Rd
Joplin, MO 64801-1509

Phone

(417) 622-7453

Fax

(417) 782-3240

NPI assigned

Jun 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• College Skyline Center LLC

  • Clinic/Center
  • Joplin, MO
  • NPI 1598764110
  Medicare reassignment NPD

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1538736699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 N DUQUESNE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011509",
            "telephone_number": "177-821-4434",
            "fax_number": "417-782-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 N DUQUESNE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011509",
            "telephone_number": "417-622-7453",
            "fax_number": "417-782-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2004033755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CAQH",
            "affiliation": "Y",
            "endpointDescription": "other",
            "affiliationName": "College Skyline Center LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "1230 N Duquesne Rd",
            "city": "Joplin",
            "state": "MO",
            "country_code": "US",
            "postal_code": "648011509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madison Haley Winfrey, PTA
• Brittany Nicole Winkfield
• Kalyn N Winnett
• Jeffrey Martin Wischmeyer, CRNA
• Tyffanie Wisener
• Adrienne Nycole Witty, B.A.
• WM. David Sweeney, D.D.S., P.C.
• Holly Wofford
• Matthew Zachary Wohlfahrt, DNAP, CRNA
• Anna Marlena Wojcicka-Mitchell, M.D.

• Counselor in Joplin, MO
• Providers in Joplin, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.