Individual provider Active NPI

David Benner

  • Case Manager/Care Coordinator
  • Lawton, OK
National Provider Identifier
1669972543
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
602 SW 38TH St
Lawton, OK 73505-6912
Phone
(580) 248-5780
NPI assigned
Feb 16, 2018
Last updated
Feb 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OK Primary

Addresses

Primary practice location

602 SW 38TH St
Lawton, OK 73505-6912

Mailing address

602 SW 38TH St
Lawton, OK 73505-6912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311003704 OK Practitioner - Mental Health Counselor 3173969227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
State of OklahomaGroup PAC ID 4486558962, 99 clinicians

Practice addresses (Care Compare)

602 SW
38TH Jim Taliaferro CMHC
Lawton, OK 73505-6912
Phone (580) 248-5780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Oklahoma CurrentSince Jan 1, 2024 Accepting new patients
State of Oklahoma Current Accepting new patients
State of Oklahoma CurrentSince Jan 1, 2024 Accepting new patients

Locations

602 SW 38th St
Lawton, OK 73505

2323 S Harvard Ave
Tulsa, OK 74114
Phone (918) 293-2140

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1669972543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 SW 38TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SW 38TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056912",
            "telephone_number": "580-248-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.