Individual provider Active NPI

Richard David Benson, M.D.

  • Nephrology Physician
  • Boone, NC
National Provider Identifier
1972506103
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
33941 Issued in NC
Practice address
400 Shadowline Dr
Suite 101
Boone, NC 28607-5089
Phone
(828) 263-8707
Fax
(828) 263-8710
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 33941 NC Primary

Addresses

Primary practice location

400 Shadowline Dr
Suite 101
Boone, NC 28607-5089

Mailing address

400 Shadowline Dr
Suite 101
Boone, NC 28607-5089
Phone (828) 263-8707

Other identifiers 1

IdentifierTypeStateIssuer
124010MedicaidSC

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33941NCMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bio-Medical Applications of Tennessee, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: richard-benson@brnephrology.e-mdsdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1972506103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SHADOWLINE DR",
            "address_2": "SUITE 101",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075089",
            "telephone_number": "828-263-8707",
            "fax_number": "828-263-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SHADOWLINE DR",
            "address_2": "SUITE 101",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075089",
            "telephone_number": "828-263-8707",
            "fax_number": "828-263-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "RICHARD",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "33941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124010",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.