Fred Benson, OWNER

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

27064077A Issued in IN

Practice address

2478 Lake Ave
Fort Wayne, IN 46805-5406

Phone

(260) 387-6396

Fax

(260) 387-6370

NPI assigned

Sep 1, 2022

Last updated

Sep 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Home Is Where the Heart Is Home Healthcare Nursing Agency, Inc

  • Home Health Agency
  • Fort Wayne, IN
  • NPI 1881314466
  NPD
• Home Is Where the Heart Is Let Me Help You Help Yourself at Home Inc

  • In Home Supportive Care Agency
  • Fort Wayne, IN
  • NPI 1861013450
  NPD

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1639899297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2478 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055406",
            "telephone_number": "260-387-6396",
            "fax_number": "260-387-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2478 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055406",
            "telephone_number": "260-387-6396",
            "fax_number": "260-387-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "FRED",
        "credential": "OWNER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "IN",
            "license": "27064077A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Bennett, RD
• Michele Bennington
• Dawn Benson, DDS
• Faith Onica Benson
• Frances Benson, RBT
• Hannah Rose Benson, MA
• Heather Benson
• Jonathan D Benson
• Sasha K Benson
• Tina Benson

• Licensed Vocational Nurse in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Licensed Vocational Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.