DR. BENJAMIN MARTIN PETTY (NPI# 1518252105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518252105 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN MARTIN PETTY |
| Credential | M.D. |
| Practice Address |
120 William Penn Plz Durham NC 27704-2150 |
| Mailing Address |
120 William Penn Plaza Durham NC 27704 |
| Practice Telephone | 9192205255 |
| Practice Fax Number | 9193131276 |
| Mailing Telephone | 9192205255 |
| Mailing Fax Number | 9193131276 |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2019-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2017-00201 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC MEDICAL LICENSE | 2017-00201 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659660967 | Benjamin D Petty | Emergency Medicine | 1701 N Senate Blvd, Room Dg412, Indianapolis, IN 46202-1239 | 2011-04-07 |
| Street Address |
120 WILLIAM PENN PLZ |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376548420 | Laura Reed Gerstner | Physician Assistant | 120 William Penn Plz, Durham, NC 27704-2150 | 2005-06-16 |
| 1861093494 | Tyler Knabe | Physical Therapist | 120 William Penn Plz, Durham, NC 27704-2150 | 2020-11-02 |
| 1366059594 | Hope R Caddell | Physical Therapist | 120 William Penn Plz, Durham, NC 27704-2150 | 2020-10-01 |
| 1881203461 | Sarah Lynne Duncan | Physician Assistant | 120 William Penn Plz, Durham, NC 27704-2150 | 2020-07-29 |
| 1023504263 | Diana Lavinder Nguyen | Specialist/Technologist | 120 William Penn Plz, Durham, NC 27704-2150 | 2018-07-10 |
| 1902308976 | Mackenzie Mallrey Eldridge | Physical Therapist | 120 William Penn Plz, Durham, NC 27704-2150 | 2018-03-06 |
| 1659870319 | Alyssa Crumpton Flowers | Physical Therapist | 120 William Penn Plz, Durham, NC 27704-2150 | 2018-02-08 |
| 1871010819 | Jared John Carl Gersch | Physical Therapist | 120 William Penn Plz, Durham, NC 27704-2150 | 2017-08-29 |
| 1013437060 | Diana Marie Frank | Physical Therapist | 120 William Penn Plz, Durham, NC 27704-2150 | 2017-06-21 |
| 1194173096 | Mark Geise | Physical Therapist | 120 William Penn Plz, Durham, NC 27704-2150 | 2016-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
| Find all providers in zip 27704 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750923215 | Carolina Health Clinic | Family Medicine | 2634 Durham Chapel Hill Blvd Ste 216, Durham, NC 27707-2800 | 2019-10-16 |
| 1235789215 | Rachel Cahoon Gray | Family Medicine | 3601 Grouse Ct, Durham, NC 27704-2488 | 2019-09-12 |
| 1285108209 | Tywana Donaldson | Family Medicine | 30 Medicine Circle, Durham, NC 27710-3038 | 2019-01-12 |
| 1396247839 | Better Life Family Center | Family Medicine | 308 S Woodcrest St Apt 5, Durham, NC 27703-3374 | 2018-02-28 |
| 1306378005 | Southpoint Family Medicine, Pllc | Family Medicine | 1515 W Nc Highway 54 Ste 130, Durham, NC 27707-5575 | 2017-03-31 |
| 1174068803 | Theodore Bruno | Family Medicine | 12 Pleasant Ter, Durham, CT 06422-2305 | 2017-01-04 |
| 1588018550 | Asiyah Zahra Mikell | Family Medicine | 516 Tall Oaks Dr, Durham, NC 27713-9358 | 2016-04-15 |
| 1114380797 | Alexa Maureen Mieses Malchuk | Family Medicine | 3708 Mayfair St., Suite 100, Durham, NC 27707 | 2016-04-01 |
| 1730593898 | Senait Fremichael Efrem | Family Medicine | 1821 Hillandale Rd Ste 24b, Durham, NC 27705-2671 | 2014-06-17 |
| 1699187963 | James Barlow | Family Medicine | 7 Mill Road Plz # C, Durham, NH 03824-3047 | 2014-05-21 |
| Find all providers in DURHAM | ||||
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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.