Individual provider Active NPI

Christopher Ryan Benton, DO

  • Emergency Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1720508260
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2019-02687 Issued in NC
Practice address
1638 Owen Dr # 138
Fayetteville, NC 28304-3424
Phone
(910) 615-4530
NPI assigned
Jun 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 2019-02687 NC Primary

Addresses

Primary practice location

1638 Owen Dr # 138
Fayetteville, NC 28304-3424

Mailing address

1638 Owen Dr # 138
Fayetteville, NC 28304-3424
Phone (910) 615-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NM, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210311001107 NC Practitioner - Emergency Medicine 7719250828 Reassigns benefits to 1 organization
I20220812000169 NM Practitioner - Emergency Medicine 7719250828 Reassigns benefits to 1 organization
I20240716002094 TN Practitioner - Emergency Medicine 7719250828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Regional Emergency Physicians, PCGroup PAC ID 3678859477, 118 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2019-02687NCMDEmergency Medicine Physician
5397TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Jun 25, 2024 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Fedko Emergency Physicians New Mexico LLC Emergency Medicine CurrentSince Jul 10, 2022 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Mar 1, 2021 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Mar 1, 2021 Accepting new patients

Locations

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

1638 Owen Dr
#138
Fayetteville, NC 28304
Phone (910) 615-4530

150 Robeson St
Fayetteville, NC 28301
Phone (910) 609-1000

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446

42121 US Highway 70
Portales, NM 88130
Phone (505) 226-3627

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720508260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR # 138",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR # 138",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "CHRISTOPHER",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2019-02687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.