Individual provider Active NPI

Robert Alan Benson, M.D.

  • Cardiovascular Disease Physician
  • Ardmore, OK
National Provider Identifier
1962442954
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
116243 Issued in OK
Practice address
731 12TH Ave NW Ste 103
Ardmore, OK 73401-5762
Phone
(580) 220-6180
Fax
(580) 226-1120
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 44588 TN
Cardiovascular Disease Physician 207RC0000X 116243 OK Primary

Addresses

Primary practice location

731 12TH Ave NW Ste 103
Ardmore, OK 73401-5762

Mailing address

7800 NW 85TH Ter
Oklahoma City, OK 73132-3385

Other identifiers 2

IdentifierTypeStateIssuer
200018790AMedicaidOK
193634602MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rbenson@direct.okheart.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040320000727 OK Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3577454560 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44588TNMDPharmacist
116243OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Ardmore, Inc. CurrentSince May 1, 2015 Accepting new patients
Mercy Hospital Ardmore, Inc Cardiovascular Disease Current Accepting new patients
Mercy Memorial Health Center Inc CurrentSince May 1, 2015 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Feb 11, 2014 Accepting new patients
Memorial Ekg Associates Past Accepting new patients
Cardiology of Tulsa Inc. Dba Cardiology Diagnostics of Tulsa Cardiovascular Disease Past Accepting new patients
McAlester Heart, PC Specialist PastSince May 14, 2006 Accepting new patients
Texas Cardiovascular Consultants, P.a. Cardiovascular Disease Past Accepting new patients
Texas Cardiovascular Consultants, PA Cardiovascular Disease Past Accepting new patients
Mercy Hospital Oklahoma City, Inc PastSince Feb 11, 2014 Accepting new patients
Texas Cardiovascular Consultants-San Angelo, PA Cardiovascular Disease Past Accepting new patients
River Park Physician Group LLC Past Accepting new patients

Locations

731 12th Ave NW
Ste 200
Ardmore, OK 73401
Phone (580) 220-6189

1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658

731 12th Ave NW
Ste 301
Ardmore, OK 73401
Phone (580) 220-6180

205 S Academy Rd
Guthrie, OK 73044
Phone (405) 282-9400

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1925/brand/4/csg/41/fhir/r4
  • Direct secure messaging: rbenson@direct.okheart.com
  • Direct secure messaging: rbenson199515@directc.mercy.net

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1962442954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 NW 85TH TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731323385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 12TH AVE NW STE 103",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015762",
            "telephone_number": "580-220-6180",
            "fax_number": "580-226-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "44588",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "116243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200018790A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193634602",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbenson@direct.okheart.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "731 12th Ave NW Ste 103",
            "city": "Ardmore",
            "state": "OK",
            "country_code": "US",
            "postal_code": "734015762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.