Individual provider Active NPI

Mary Hannah Benek, CNM MN

  • Advanced Practice Midwife
  • Waycross, GA
National Provider Identifier
1689088874
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN063022 Issued in GA
Practice address
505 City Blvd
Waycross, GA 31501-8003
Phone
(912) 490-2229
Fax
(912) 490-9023
NPI assigned
Jun 16, 2014
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN063022 GA Primary

Addresses

Primary practice location

505 City Blvd
Waycross, GA 31501-8003

Mailing address

505 City Blvd
Waycross, GA 31501-8003
Phone (912) 490-2229

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MARY.BENEK@hca5.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140922000601 GA Practitioner - Certified Nurse Midwife (CNM) 9436378627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.07 of 100Reported as group
Quality
81.4
Promoting interoperability
99
Improvement activities
40
Cost
71.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN063022GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jun 3, 2014 Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Current Accepting new patients

Locations

316 Shirley Ave
Douglas, GA 31533
Phone (912) 383-0815

1921 Alice St
Ste 4B
Waycross, GA 31501
Phone (912) 285-5690

505 City Blvd
Waycross, GA 31501
Phone (912) 490-2229

Interoperability endpoints

  • Direct secure messaging: mary.benek@hca5.eclinicaldirectplus.com

Organizations & group practices 2

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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1689088874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 CITY BLVD",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018003",
            "telephone_number": "912-490-2229",
            "fax_number": "912-490-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CITY BLVD",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018003",
            "telephone_number": "912-490-2229",
            "fax_number": "912-490-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEK",
        "first_name": "MARY",
        "middle_name": "HANNAH",
        "name_prefix": "Mrs.",
        "credential": "CNM MN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN063022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MARY.BENEK@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "505 City Blvd",
            "city": "Waycross",
            "state": "GA",
            "country_code": "US",
            "postal_code": "315018003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.