BENJAMIN CALE FRIESEN (NPI# 1366905275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366905275 |
| Entity Type | Individual |
| Full Name | BENJAMIN CALE FRIESEN |
| Practice Address |
1915 Lake Ave Plymouth IN 46563-9366 |
| Mailing Address |
56765 County Road 23 Bristol IN 46507-9516 |
| Practice Telephone | 5749484000 |
| Mailing Telephone | 5742388372 |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
28203358A | IN | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71008991A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANP LICENSE | 71008991A | 01 |
| INDIANA STATE BOARD OF NURSING | 28203358A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 56765 County Road 23, Bristol, IN 465079516 | 5742388372 |
| Street Address |
1915 LAKE AVE |
| City | PLYMOUTH |
| State | IN |
| Zip Code | 46563-9366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619977543 | Guy Kedziora | Radiology | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2005-07-21 |
| 1598387250 | Dana Oberg | Hospitalist | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2020-05-15 |
| 1902345879 | Aimee Clady | Nurse Practitioner | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2017-02-13 |
| 1013384262 | Jessica Cooper | Nurse Practitioner | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2015-08-24 |
| 1093102162 | Saint Joseph Regional Medical Center - Plymouth Campus Inc | Non-Pharmacy Dispensing Site | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2015-04-16 |
| 1821402876 | Saint Joseph Regional Medical Center Plymouth Campus, Inc | Internal Medicine | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2014-06-18 |
| 1144634742 | Christopher A Chesnut | Emergency Medicine | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2014-06-12 |
| 1669800728 | Muhammad M Hussain | Internal Medicine | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2013-10-28 |
| 1033430681 | Monica Esquivel | Dietitian, Registered | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2010-06-17 |
| 1184825283 | Brion B. Shin | Radiology | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2007-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811547748 | Steven N Wolff | Pharmacist | Walmart #1978, 2505 North Oak Drive, Plymouth, IN 46563 | 2019-09-12 |
| 1295280923 | Multi-county Ems LLC | Ambulance | 5034 Redwood Road, Plymouth, IN 46563 | 2016-08-23 |
| 1356473060 | Donna Michelle Eggers | Speech-Language Pathologist | 1915 Lake Avenue, Plymouth, IN 46563 | 2007-03-09 |
| 1629103684 | Marshall County Council On Aging | Home Delivered Meals | 1305 W Harrison Street, Plymouth, IN 46563 | 2007-02-22 |
| 1063561272 | Associates In Clinical Psychology PC | Psychiatric Residential Treatment Facility | 317 West Monroe St, Plymouth, IN 46563 | 2007-01-09 |
| 1316005911 | Michiana Eye Center LLC | Optometrist | 320 Meadow Ln, Plymouth, IN 46563 | 2006-12-05 |
| 1487722948 | Allen Edward Reese | Hearing Instrument Specialist | 322 N. Michigan St., Suite C, Plymouth, IN 46563 | 2006-12-01 |
| 1508932252 | Thomas A Miller | Chiropractor | 1071 Lincolnway E, Plymouth, IN 46563 | 2006-11-27 |
| 1679540991 | Mukesh Garg | Internal Medicine | 2349 Lake Ave Ste 99, Plymouth, IN 46563 | 2006-03-06 |
| 1982686242 | Woodlawn Hospital | Skilled Nursing Facility | 9601 Union Rd, Plymouth, IN 46563 | 2005-11-14 |
| Find all providers in zip 46563 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477180826 | Stephanie Jordan | Nurse Practitioner | 22 Cranberry Rd, Plymouth, MA 02360-2857 | 2020-03-25 |
| 1710543863 | Kristen Marie Kubik | Nurse Practitioner | 13970 Oakland Ct, Plymouth, MI 48170-5292 | 2019-05-14 |
| 1679931505 | Hillary Costa | Nurse Practitioner | 45 Resnik Rd Ste 302, Plymouth, MA 02360-4883 | 2016-02-06 |
| 1811374747 | Jill Marie Geer | Nurse Practitioner | 510 W Adams St, Suite 150, Plymouth, IN 46563-1765 | 2015-04-29 |
| 1740677921 | Inner Banks Family Medicine | Nurse Practitioner | 543 Us Highway 64 W, Plymouth, NC 27962-2144 | 2015-04-24 |
| 1952706210 | Elizabeth Nelson-frazier | Nurse Practitioner | 50 Aldren Road, Plymouth, MA 02061-2711 | 2014-10-29 |
| 1902206899 | Kathleen E Steensma | Nurse Practitioner | 15700 37th Ave N. #110, Plymouth, MN 55446 | 2014-08-27 |
| 1730595943 | Nicole Lee | Nurse Practitioner | 10 Bay Cliff Cir, Plymouth, MA 02360-1458 | 2014-07-08 |
| 1700122579 | Renae Charlene Atkins | Nurse Practitioner | 2855 Miller Dr Ste 119, Plymouth, IN 46563-8091 | 2012-12-21 |
| 1396097069 | Kristin Lynn Spencer | Nurse Practitioner | 3007 Harbor Lane North, Park Nicollet Clinic Plymouth - Family Medicine, Plymouth, MN 55447 | 2012-10-05 |
| Find all providers in PLYMOUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.