Individual provider Active NPI

Benjaman James Gilham, AUD, D

  • Audiologist
  • Renton, WA
National Provider Identifier
1548548126
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
LD60233276 Issued in WA
Practice address
2921 Naches Ave SW
Renton, WA 98057-2617
Phone
(206) 630-5737
Fax
(206) 630-1601
NPI assigned
Jul 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X LD60233276 WA Primary

Addresses

Primary practice location

2921 Naches Ave SW
Renton, WA 98057-2617

Mailing address

2921 Naches Ave SW
Renton, WA 98057-2617
Phone (206) 630-5737

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110929000705 WA Practitioner - Qualified Audiologist 8628249315 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Washington CurrentSince Sep 1, 2016 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 4, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 4, 2022 Accepting new patients
Harborview Medical Center CurrentSince Sep 1, 2016 Accepting new patients
Harborview Medical Center CurrentSince Sep 1, 2016 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
University of Washington CurrentSince Sep 1, 2016 Accepting new patients

Locations

2921 Naches Ave SW
Renton, WA 98057
Phone (206) 630-1330

4333 Brooklyn Ave NE
Seattle, WA 98195
Phone (206) 221-1700

325 9th Ave
Seattle, WA 98104
Phone (206) 731-3000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1548548126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 NACHES AVE SW",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572617",
            "telephone_number": "206-630-5737",
            "fax_number": "206-630-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 NACHES AVE SW",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572617",
            "telephone_number": "206-630-5737",
            "fax_number": "206-630-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILHAM",
        "first_name": "BENJAMAN",
        "middle_name": "JAMES",
        "credential": "AUD, D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-29",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD60233276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2921 Naches Ave SW",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980572617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.