Individual provider Active NPI

Molly Anne Benedum, MD

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1790076248
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37402 Issued in SC
Practice address
877 W Faris Rd Ste a
Greenville, SC 29605-4296
Phone
(864) 455-7800
Fax
(864) 455-9037
NPI assigned
May 2, 2011
Last updated
Sep 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 173730 NC
Family Medicine Physician 207Q00000X 37402 SC Primary

Addresses

Primary practice location

877 W Faris Rd Ste a
Greenville, SC 29605-4296

Mailing address

1 Independence PT
Ste 212
Greenville, SC 29615-4545
Phone (864) 797-6306

Other identifiers 1

IdentifierTypeStateIssuer
374026MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191104002307 NC Practitioner - Family Practice 2860613585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Regional Medical Associates IncGroup PAC ID 5799877817, 147 clinicians

Practice addresses (Care Compare)

148 Hwy 105 Ext
Suite 102
Boone, NC 28607-5682
Phone (828) 386-2222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173730NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Regional Medical Associates, Inc. Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
Appalachian Regional Medical Associates Inc Family Medicine CurrentSince Oct 1, 2019 Accepting new patients

Locations

148 Highway 105 Ext
Ste 102
Boone, NC 28607
Phone (828) 257-2946

211 Milton Brown Heirs Rd
Boone, NC 28607
Phone (828) 264-6720

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

Interoperability endpoints

  • Direct secure messaging: mbenedum460460@direct.unc.nchie.net
  • Direct secure messaging: mollybenedum@arhs.allscriptsdirect.net

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.

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": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1790076248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 W FARIS RD STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054296",
            "telephone_number": "864-455-7800",
            "fax_number": "864-455-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDUM",
        "first_name": "MOLLY",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "173730",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "37402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374026",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.