Advanced Neurologic Associates, Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

ADVANCED NEUROLOGIC ASSOCIATES, INC

Practice address

1250 Fulton St
Port Clinton, OH 43452-9296

Phone

(419) 483-2403

Fax

(419) 484-1203

NPI assigned

Aug 2, 2010

Organization subpart

No

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

Authorized official

Name

Steven Benedict, MD

Title

President

Phone

(419) 483-2403

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1588978563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5433 STATE ROUTE 113",
            "city": "BELLEVUE",
            "state": "OH",
            "postal_code": "448119708",
            "telephone_number": "419-483-2403",
            "fax_number": "419-484-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434529296",
            "telephone_number": "419-483-2403",
            "fax_number": "419-484-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED NEUROLOGIC ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "BENEDICT",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-483-2403",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CL1664",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2383620",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Port Clinton, OH
• Providers in Port Clinton, OH by specialty
• Neurology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; 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.