Boulevard East Family and Occupational Medicine Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BOULEVARD EAST FAMILY AND OCCUPATIONAL MEDICINE INC

Practice address

222 Bowman St
Suite 3
Morristown, TN 37813-3856

Phone

(423) 318-1185

Fax

(423) 318-1015

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Moses Benaiah Benavides, MDNPI 1326332768

Title

Ceo

Phone

(423) 318-1185

Specialties & licenses 9

Addresses

Other names 1

• Moses Benavides MD Other name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Moses Benaiah Benavides, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Sells, AZ
  • NPI 1326332768
  NPD (past) Authorized official
• Zinamong Monzon-Benavides, DDS

  • General Practice Dentistry
  • Morristown, TN
  • NPI 1750389961
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609948009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 W MORRIS BLVD",
            "address_2": "SUITE B",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "37813",
            "telephone_number": "423-318-1185",
            "fax_number": "423-318-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BOWMAN ST",
            "address_2": "SUITE 3",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378133856",
            "telephone_number": "423-318-1185",
            "fax_number": "423-318-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD EAST FAMILY AND OCCUPATIONAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BENAVIDES",
        "authorized_official_first_name": "MOSES",
        "authorized_official_middle_name": "BENAIAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-318-1185",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "TN",
            "license": "MD0000040290",
            "primary": false
        },
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "TN",
            "license": "MD0000040290",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "DS0000007577",
            "primary": false
        },
        {
            "code": "261QM1103X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military Ambulatory Procedure Visits Operational (Transportable)",
            "state": "TN",
            "license": "MD0000040290",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TN",
            "license": "MD 0000040290",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "MD0000040290",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "TN",
            "license": "MD0000040290",
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "TN",
            "license": "MD0000040290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moses Benavides MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tabitha Bolden, LMT
• Davina Mae Bolinger, B.A.
• James N Bond, DPT, ATC, LAT
• Mark Booher, B.S.
• Thomas Jeffrey Borg
• Lori M Bouton, APN
• Genevieve Bower, RN, BSN, MS, IBCLC
• Tina E Bowles, APRN
• Haley Bowlin
• J Sidney Boyd, DDS

• Family Medicine Physician in Morristown, TN
• Providers in Morristown, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.