John Anthony Benson, P.T.

Individual provider Active NPI Physical Therapist · Fenton, MI

NPI 1720021322 · NPPES record last updated Nov 24, 2007

Key facts

NPI
1720021322
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501003785 (MI)
Practice address
400 Rounds Dr
Fenton, MI 48430-1724
Phone
(810) 750-1996
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Michigan LLC (156 clinicians)

Practice addresses (Care Compare)

400 Rounds Dr
Fenton, MI 48430-1724
Phone (810) 750-1996

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20080121000101 MI Practitioner - Physical Therapist in Private Practice 6608957212 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5501003785MIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501003785 MI Yes

Addresses

Primary practice location

400 Rounds Dr
Fenton, MI 48430-1724

Mailing address

5440 Wildwood Dr
Howell, MI 48843-9184
Phone (810) 750-1996

Other providers in Fenton, MI

All providers in Fenton, MI · Physical Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.