Individual provider Active NPI

Eugene Elliot Benjamin, M.D.

  • Neurology Physician
  • Bristol, TN
National Provider Identifier
1619938867
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
28842 Issued in NC
Practice address
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone
(423) 844-1121
Fax
(423) 230-8502
NPI assigned
Mar 29, 2006
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 75482 TN
Neurology Physician 2084N0400X 28842 NC Primary
Neurology Physician 2084N0400X D78821 MD
Hospitalist Physician 208M00000X 75482 TN

Addresses

Primary practice location

1 Medical Park Blvd
Bristol, TN 37620-7430

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-3628

Other practice location 2

410 N State Of Franklin Rd Ste 135
Johnson City, TN 37604-6972
Phone (423) 431-2350

Other practice location 3

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7536

Other practice location 4

510 Butler Ave
Martinsburg, WV 25401-9990
Phone (304) 263-0811 ext. 3486

Other practice location 5

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 543-7536

Other practice location 6

1910 Jake Alexander Blvd W Ste 102
Salisbury, NC 28147-1163
Phone (704) 637-1779

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebenjamin664611@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161114000324 MD Practitioner - Neurology 3870776776 Reassigns benefits to 2 organizations
I20170418002623 ND Practitioner - Neurology 3870776776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians

Practice addresses (Care Compare)

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.92 of 100Reported as group
Quality
74.47
Promoting interoperability
92
Improvement activities
40
Cost
75.27

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28842NCMDPharmacist
75482TNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Mar 11, 2017 Accepting new patients
Tidalhealth Peninsula Regional, Inc. Current Accepting new patients
St. Alexius Medical Center CurrentSince Mar 11, 2017 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Sep 1, 2020 Accepting new patients
Blue Ridge Medical Management Corporation Neurology CurrentSince Jan 1, 2026 Accepting new patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Sep 18, 2016 Accepting new patients
Wellmont Medical Associates Inc Hospitalist CurrentSince Feb 1, 2026 Accepting new patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Sep 18, 2016 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jan 1, 2026 Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients
Community Memorial Hospital Hospitalist Past Accepting new patients

Locations

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

106 Milford St
Ste 201
Salisbury, MD 21804
Phone (410) 543-1616

145 E Carroll St
Salisbury, MD 21801
Phone (410) 546-6400

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

410 N State of Franklin Rd
Ste 135
Johnson City, TN 37604
Phone (423) 431-2350

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

Organizations & group practices 12

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1619938867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-1121",
            "fax_number": "423-230-8502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-3628",
            "fax_number": "423-230-8502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 N State Of Franklin Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046972",
            "country_code": "US",
            "telephone_number": "423-431-2350",
            "fax_number": "423-431-2372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E Carroll St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "21801",
            "country_code": "US",
            "telephone_number": "410-543-7536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 Butler Ave",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254019990",
            "country_code": "US",
            "telephone_number": "304-263-0811 x3486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E Carroll St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015422",
            "country_code": "US",
            "telephone_number": "410-543-7536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1910 Jake Alexander Blvd W Ste 102",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281471163",
            "country_code": "US",
            "telephone_number": "704-637-1779",
            "fax_number": "704-637-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "EUGENE",
        "middle_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "75482",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "28842",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "D78821",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "75482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebenjamin664611@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "510 Butler Ave",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254019990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.