Active NPI
John Walter Benus, DPM
- Podiatrist
- Pascagoula, MS
National Provider Identifier
1720195860
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Mar 20, 2023.
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 80030
- Practice address
- 4311 Chicot Street
Pascagoula, MS 39581-4701 - Phone
- (228) 762-9531
- Fax
- (228) 762-9588
- NPI assigned
- Aug 24, 2006
- Last updated
- Sep 27, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 80030 | MS | Primary |
Addresses
Primary practice location
4311 Chicot Street
Pascagoula, MS 39581-4701
Mailing address
4311 Chicot Street
Pascagoula, MS 39581-4701
Phone (228) 762-9531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00012898 | Medicaid | MS |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80030 | MS | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569542400000",
"number": "1720195860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4311 CHICOT STREET",
"city": "PASCAGOULA",
"state": "MS",
"postal_code": "395814701",
"telephone_number": "228-762-9531",
"fax_number": "228-762-9588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4311 CHICOT STREET",
"city": "PASCAGOULA",
"state": "MS",
"postal_code": "395814701",
"telephone_number": "228-762-9531",
"fax_number": "228-762-9588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENUS",
"first_name": "JOHN",
"middle_name": "WALTER",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2019-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MS",
"license": "80030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00012898",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pascagoula, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.