NPIMap

Organization Active NPI

Imed Internal Medicine PA

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1548245178
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IMED INTERNAL MEDICINE PA
Practice address
255 E Sonterra Blvd
Suite 100
San Antonio, TX 78258-3990
Phone
(210) 404-0000
Fax
(210) 581-0120
NPI assigned
Dec 6, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Vernon Roger Benson, M.D.F.A.C.P.NPI 1487638011
Title
President
Phone
(210) 404-0000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

255 E Sonterra Blvd
Suite 100
San Antonio, TX 78258-3990

Mailing address

PO Box 867
San Antonio, TX 78293-0867
Phone (210) 404-0000

Other identifiers 1

IdentifierTypeStateIssuer
0051EBOtherTXBLUE CROSS IDENTIFIER

National Provider Directory

National Provider Directory

Locations

255 E Sonterra Blvd
Ste 100
San Antonio, TX 78258
Phone (210) 404-0000

540 Oak Centre Dr
Ste 240
San Antonio, TX 78258
Phone (210) 404-0000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548245178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782930867",
            "telephone_number": "210-404-0000",
            "fax_number": "210-581-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E SONTERRA BLVD",
            "address_2": "SUITE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583990",
            "telephone_number": "210-404-0000",
            "fax_number": "210-581-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMED INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-404-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.F.A.C.P."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS IDENTIFIER",
            "identifier": "0051EB",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.