Active NPI
Benjamin Darter, PT
- Physical Therapist
- San Antonio, TX
National Provider Identifier
1902009053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 03513
- Practice address
- 3851 Roger Brooke Dr
Fort Sam Houston
San Antonio, TX 78234-4501 - Phone
- (210) 619-6190
- NPI assigned
- Jun 7, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 03513 | IA | Primary |
Addresses
Primary practice location
3851 Roger Brooke Dr
Fort Sam Houston
San Antonio, TX 78234-4501
Mailing address
12900 E Loop 1604 N Apt 532
Universal City, TX 78148-3175
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03513 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902009053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12900 E LOOP 1604 N APT 532",
"city": "UNIVERSAL CITY",
"state": "TX",
"postal_code": "781483175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3851 ROGER BROOKE DR",
"address_2": "FORT SAM HOUSTON",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782344501",
"telephone_number": "210-619-6190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARTER",
"first_name": "BENJAMIN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "03513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.