Benedict Johnson Middleton IV, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

222426 Issued in OK

Practice address

1130 E Lansing St
Broken Arrow, OK 74012-2429

Phone

(918) 258-9111

NPI assigned

Mar 25, 2025

Last updated

Mar 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Oklahoma Physician Network IncGroup PAC ID 8527224252, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIHBDD

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.

• Northeast Oklahoma Physician Network Inc

  • Family Medicine Physician
  • Broken Arrow, OK
  • NPI 1114283025
  Medicare reassignment Care Compare group NPD
• Northeast Oklahoma Physician Network Inc

  dba Broken Arrow Urgent Care

  • Urgent Care Clinic/Center
  • Broken Arrow, OK
  • NPI 1205190501
  NPD

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1700688371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3576 S WINSTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352045",
            "telephone_number": "918-406-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E LANSING ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122429",
            "telephone_number": "918-258-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "BENEDICT",
        "middle_name": "JOHNSON",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "222426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Metro Tulsa Foot & Ankle Specialist PLLC
• Michael a. Kincaid, D.D.S.
• Michael O. Baird DDS, PC
• Joseph Caleb Michela
• Michelle L Fugitt DO PLLC
• Tara Lynn Midgley, COTA/L
• Midwest Cpap and Sleep Technologies
• Dawn Mihok
• Anthea Miller
• David W Miller, MD

• Family Nurse Practitioner in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.