Oliver Benton IV, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

2022-01826 Issued in NC

Practice address

140 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6185

Phone

(336) 245-2100

Fax

(336) 768-7782

NPI assigned

May 11, 2017

Last updated

Mar 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Piedmont Stone Center PLLCGroup PAC ID 2961315718, 71 clinicians

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
• Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Piedmont Stone Center PLLC

  • Lithotripsy Clinic/Center
  • Winston Salem, NC
  • NPI 1700827409

  Urology

  Medicare reassignment Care Compare group NPD
• Forsyth Memorial Hospital, Inc

  dba Novant Health Urology

  • Urology Physician
  • Winston Salem, NC
  • NPI 1235629890
  NPD
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Heart & Vascular Institute - Frontis Plaza

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Urology

  • Urology Physician
  • Clemmons, NC
  • NPI 1629720453
  NPD
• Forsyth Memorial Hospital, Inc

  dba Novant Health Surry Medical Associates

  • Family Medicine Physician
  • Mount Airy, NC
  • NPI 1295783108
  NPD (past)
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Medical Park Hospital LLC

  dba Novant Health Medical Park Hospital

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1538111828
  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1558897488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 KIMEL PARK DR STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036185",
            "telephone_number": "336-245-2100",
            "fax_number": "336-768-7782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Alcoa Hwy # U-11",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "865-305-9230",
            "fax_number": "865-305-6958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTON",
        "first_name": "OLIVER",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2022-01826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "obenton1058116@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "140 Kimel Park Dr Ste 100",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana Paige Bentley, PHD, LCMHCS
• Katlynn Nicole Bentley
• Lynn Bentley, LPCA
• Don Boyce Benton, DDS
• Lana Benton, RN
• Mila Berdecia, MD
• Lesley Berenson, LCSW
• Meghan Berger, M.A., NCC, LCMHCA
• Valerie Clarke Berger, M.D.
• William Scott Berger, M.D.

• Urology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Urology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.