Individual provider Active NPI

Naomi Jo Bennion, LPN

  • Licensed Practical Nurse
  • Fillmore, NY
National Provider Identifier
1669638839
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
293867 Issued in NY
Practice address
10908 Route 19
Fillmore, NY 14735
Phone
(585) 567-8296
NPI assigned
Aug 6, 2008
Last updated
Aug 6, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 293867 NY Primary

Addresses

Primary practice location

10908 Route 19
Fillmore, NY 14735

Mailing address

9719 County Road 15
Fillmore, NY 14735-8760
Phone (585) 567-8315

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
293867NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1669638839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9719 COUNTY ROAD 15",
            "city": "FILLMORE",
            "state": "NY",
            "postal_code": "147358760",
            "telephone_number": "585-567-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10908 ROUTE 19",
            "city": "FILLMORE",
            "state": "NY",
            "postal_code": "14735",
            "telephone_number": "585-567-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNION",
        "first_name": "NAOMI",
        "middle_name": "JO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "293867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fillmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.