Individual provider Active NPI

John Robert Benedict, PHARMD

  • Pharmacist
  • Ithaca, NY
National Provider Identifier
1821310186
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
053697 Issued in NY
Practice address
2309 N Triphammer Rd
Ithaca, NY 14850-1060
Phone
(607) 257-2011
Fax
(607) 266-0943
NPI assigned
Feb 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 053697 NY Primary

Addresses

Primary practice location

2309 N Triphammer Rd
Ithaca, NY 14850-1060

Mailing address

300 Halseyville Rd
Ithaca, NY 14850-9232
Phone (607) 869-5033

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
053697NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1821310186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HALSEYVILLE RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509232",
            "telephone_number": "607-869-5033",
            "fax_number": "607-869-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 N TRIPHAMMER RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501060",
            "telephone_number": "607-257-2011",
            "fax_number": "607-266-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-26",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "053697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.