DR. KENNETH JAMES BENJAMIN (NPI# 1932104007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932104007 |
| Entity Type | Individual |
| Full Name | DR. KENNETH JAMES BENJAMIN |
| Credential | D.P.M. |
| Practice Address |
198 Thomas Johnson Dr Ste 4 Frederick MD 21702-4398 |
| Practice Telephone | 3016959669 |
| Practice Fax Number | 3016950346 |
| Mailing Telephone | 3016959669 |
| Mailing Fax Number | 3016950346 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2007-07-08 |
| NPI Deactivation Date | 03/18/2006 |
| NPI Reactivation Date | 2006-04-04 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
00592 | MD | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | AETNA HEALTHCARE | 998448 | 01 |
| MD | BLUE CROSS BLUE SHIELD | K374 | 01 |
| MD | AETNA HEALTHCARE | 4081479 | 01 |
| MD | UNITED HEALTHCARE | 385141 | 01 |
| DC | BLUE CROSS BLUE CHOICE | 9502 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215419536 | Kenneth Benjamin | Chiropractor | 12550 Biscayne Blvd Ste 404, North Miami, FL 33181-2544 | 2018-09-04 |
| 1245344928 | Kenneth James Benjamin | Emergency Medicine | 902 N 7th St, Cordele, GA 31015-3234 | 2006-08-18 |
| Street Address |
198 THOMAS JOHNSON DR STE 4 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225587538 | Oasis Therapy | Physical Therapist | 198 Thomas Johnson Dr, Suite 19, Frederick, MD 21702-4398 | 2016-09-27 |
| 1053718544 | Mustardseed Healthcare Services, LLC | Home Health | 198 Thomas Johnson Dr, Ste 205, Frederick, MD 21702-4398 | 2014-11-26 |
| 1477986099 | Ghulam Abbas, Md LLC | Internal Medicine | 198 Thomas Johnson Dr, 104, Frederick, MD 21702-4398 | 2013-08-19 |
| 1700128436 | Alysia Mason Feuer | Dietitian, Registered | 198 Thomas Johnson Dr, Suite 14, Frederick, MD 21702-4398 | 2013-03-20 |
| 1245582832 | Potomac Healthcare Alliance LLC | Clinic/Center | 198 Thomas Johnson Dr, Suite 5, Frederick, MD 21702-4398 | 2012-10-08 |
| 1700137940 | John P O'brien | Social Worker | 198 Thomas Johnson Dr, Ste 9, Frederick, MD 21702-4443 | 2012-09-27 |
| 1063786044 | Dr. Riku Mukherjee, D.d.s., P.a. | Dentist | 198 Thomas Johnson Dr, Suite 18, Frederick, MD 21702-4398 | 2012-03-08 |
| 1568731917 | David Morra | Dentist | 198 Thomas Johnson Dr, Frederick, MD 21702-4398 | 2011-12-14 |
| 1164666905 | Brett Everette Weedon | Dentist | 198 Thomas Johnson Dr, Suite 203, Frederick, MD 21702-4398 | 2009-04-23 |
| 1568623577 | Amaris M Little | Dentist | 198 Thomas Johnson Dr, Suite #201, Frederick, MD 21702-4398 | 2008-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
| Find all providers in zip 21702 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699718379 | Larry K Birriel | Podiatrist | 1433 Porter St, Fort Detrick Army Garrison, Frederick, MD 21702-9211 | 2006-06-13 |
| 1467413195 | Brenna Leigh Steinberg | Podiatrist | 141 Thomas Johnson Dr, Suite 170, Frederick, MD 21702-4530 | 2006-03-31 |
| 1164408746 | David Allen Lieb | Podiatrist | 10 Hillcrest Dr, Suite 25, Frederick, MD 21703-6107 | 2005-12-15 |
| 1912902545 | Jennifer E Mullendore | Podiatrist | 182 Thomas Johnson Dr Ste 204, Frederick, MD 21702-4557 | 2005-06-20 |
| 1144602244 | Jacqueline Chen | Podiatrist | 141 Thomas Johnson Dr Ste 170, Frederick, MD 21702 | 2015-06-24 |
| 1619300779 | Isaac Kwaku Neequaye | Podiatrist | 141 Thomas Johnson Dr, Suite 170, Frederick, MD 21702-4502 | 2013-08-13 |
| 1619317419 | Sana Jahan Shamim | Podiatrist | 63 Thomas Johnson Dr, Suite C, Frederick, MD 21702-4384 | 2013-06-26 |
| 1386943561 | Laser Podiatry Associates, LLC | Podiatrist | 182 Thomas Johnson Dr Ste 204, Frederick, MD 21702-4557 | 2011-03-27 |
| 1902135296 | Coralia Terol | Podiatrist | 141 Thomas Johnson Dr, Suite 170, Frederick, MD 21702-4502 | 2009-12-15 |
| 1497904106 | Yenisey Yanes | Podiatrist | 141 Thomas Johnson Dr, Suite 170, Frederick, MD 21702-4502 | 2008-09-17 |
| Find all providers in FREDERICK | ||||
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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.