Individual provider Active NPI

Adina Jospehine Benavidez

  • Driver
  • Fort Collins, CO
National Provider Identifier
1649866336
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
170610569 Issued in CO
Practice address
2300 W County Road 38 E Lot 268
Fort Collins, CO 80526-6466
Phone
(970) 222-5326
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193400000X SINGLE SPECIALTY GROUP 172A00000X 170610569 CO Primary

Addresses

Primary practice location

2300 W County Road 38 E Lot 268
Fort Collins, CO 80526-6466

Mailing address

2300 W County Road 38 E Lot 268
Fort Collins, CO 80526-6466
Phone (970) 222-5326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
170610569COMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1649866336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W COUNTY ROAD 38 E LOT 268",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266466",
            "telephone_number": "970-222-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W COUNTY ROAD 38 E LOT 268",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266466",
            "telephone_number": "970-222-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDEZ",
        "first_name": "ADINA",
        "middle_name": "JOSPEHINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": "CO",
            "license": "170610569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.