Active NPI
Coral Rochelle Benge, PA-C
- Physician Assistant
- McDonough, GA
National Provider Identifier
1922040781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 003067
- Practice address
- 1631 Highway 20 W
McDonough, GA 30253-7311 - Phone
- (678) 583-0241
- Fax
- (678) 583-0261
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 003067 | GA | Primary |
Addresses
Primary practice location
1631 Highway 20 W
McDonough, GA 30253-7311
Mailing address
1631 Highway 20 W
McDonough, GA 30253-7311
Phone (678) 583-0241
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Doctor'S Office, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Stockbridge, GA
- NPI 1578884516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320710400000",
"number": "1922040781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 HIGHWAY 20 W",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302537311",
"telephone_number": "678-583-0241",
"fax_number": "678-583-0261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 HIGHWAY 20 W",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302537311",
"telephone_number": "678-583-0241",
"fax_number": "678-583-0261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENGE",
"first_name": "CORAL",
"middle_name": "ROCHELLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2011-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "003067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.