ETHAN MICHAEL BENNING (NPI# 1104168582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104168582 |
| Entity Type | Individual |
| Full Name | ETHAN MICHAEL BENNING |
| Credential | MD |
| Practice Address |
3001 Broadmoor Blvd Ne Rio Rancho NM 87144 |
| Mailing Address |
933 Bradbury Dr Se Ste 2222 Albuquerque NM 87106-4375 |
| Practice Telephone | 5059947000 |
| Mailing Telephone | 5052726487 |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | MD2019-0664 | NM | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 27993 | WV | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1100 Fort Pierpont Dr Ste 101, Morgantown, WV 265081329 | 3042411100 | |
| 2040 W Charleston Blvd Ste 302, Las Vegas, NV 891022230 | 7026712273 |
| Street Address |
3001 BROADMOOR BLVD NE |
| City | RIO RANCHO |
| State | NM |
| Zip Code | 87144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083696546 | Paul Afek | Family Medicine | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2005-11-18 |
| 1477188134 | Sandra Denise Hobson | Nurse Practitioner | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2020-03-03 |
| 1548807050 | Camella L Hernandez | Nurse Practitioner | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2019-12-03 |
| 1013470335 | David Kim Hoang | Registered Nurse | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2019-04-12 |
| 1477044121 | Elizabeth Reed | Nutritionist | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2018-05-29 |
| 1306358981 | Ashley Nichole Quintana | Nurse Practitioner | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2017-11-03 |
| 1245759463 | Victoria Freeman | Physician Assistant | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144 | 2017-09-19 |
| 1346793445 | Mckenzie Mack Lake | Nurse Practitioner | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2016-07-26 |
| 1902259708 | Paula E Smith | Nurse Practitioner | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2016-07-15 |
| 1417319427 | Michael Francis Spigner | Emergency Medicine | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2016-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368916 | Hannah's Helping Hands, LLC | Home Health | 7033 Kalgan Rd. Ne, Rio Rancho, NM 87144 | 2020-05-19 |
| 1740823673 | Valentina Baldenado | Technician | 7011 Overview Rd Ne, Rio Rancho, NM 87144 | 2019-10-23 |
| 1891341996 | Chelsea Spraberry | Psychologist | 2600 College Blvd, 2nd Floor, Rio Rancho, NM 87144 | 2019-08-14 |
| 1760920714 | Veronica Villa-chavez | Specialist/Technologist, Other | 900 Starry Sky Ave Ne, Rio Rancho, NM 87144 | 2017-02-09 |
| 1053790709 | Bessie Abraham | Anesthesiology | Srmc - Unm Sandoval Regional Medical Center, 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144 | 2015-05-28 |
| 1326473638 | Lisa Nicole Melendez | Massage Therapist | 3610 Havasu Falls St Ne, Rio Rancho, NM 87144 | 2013-09-05 |
| 1245674563 | Courtney Meredith Lapham-simpson | Emergency Medicine | 3001 Broadmoor Blvd. Ne, Rio Rancho, NM 87144 | 2013-04-18 |
| 1164772232 | Annmarie Boyd | Social Worker | 5737 Quay Dr Ne, Rio Rancho, NM 87144 | 2012-09-14 |
| 1346590833 | Rio Rancho Public Schools | Local Education Agency (LEA) | 1600 Loma Colorado Ne, Rio Rancho, NM 87144 | 2012-09-12 |
| 1356690804 | Geno Health Services LLC | Community/Behavioral Health | 3560 Shiloh Rd. Ne, Rio Rancho, NM 87144 | 2012-08-30 |
| Find all providers in zip 87144 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073777140 | Jennifer Diane Bishop | Surgery | 2400 Unser Blvd Ne, 1st Floor, 2nd Tower, Rio Rancho, NM 87124 | 2008-07-17 |
| 1114138906 | Jeffery Brown | Surgery | 2400 Unser Blvd Se Ste 8200, Rio Rancho, NM 87124 | 2007-05-24 |
| 1295121481 | Anna Lise Koenig | Surgery | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2015-04-14 |
| 1760742787 | Patricia Souchon-sanchez | Surgery | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2012-05-23 |
| 1194850867 | Steven N Bock | Surgery | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522986 | Organ Peak Surgery | Surgery | 141 N Roadrunner Pkwy Ste 220, Las Cruces, NM 88011-2001 | 2020-09-09 |
| 1578090296 | Teddi Swidinsky | Surgery | 108 Legion Dr Ste B, Las Vegas, NM 87701-4898 | 2017-05-11 |
| 1871989228 | Jaideep Dasgupta | Surgery | Unm School of Medicine Msc 10 5610, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2015-04-13 |
| 1902148885 | Fermin Miguel Fontan | Surgery | 2100 S Triviz Dr Ste G, Las Cruces, NM 88001-0601 | 2013-03-19 |
| 1134476120 | John Garrett Cope | Surgery | 5304 Cortaderia Pl Ne, Albuquerque, NM 87111-8058 | 2012-08-08 |
| 1265790216 | St. Vincent Hospital | Surgery | 1213 Gusdorf Road, Taos, NM 87571 | 2012-04-27 |
| 1942568209 | St. Vincent Hospital | Surgery | 2237 Trinity Dr, Los Alamos, NM 87544-2385 | 2012-04-24 |
| 1154613248 | Julie Ann Wesp | Surgery | 1631 Hospital Dr Ste 240, Santa Fe, NM 87505-7691 | 2011-05-06 |
| 1639469174 | David Hoang | Surgery | 715 Dr Martin Luther King Jr Ave Ne Ste 301, Albuquerque, NM 87102-3668 | 2011-04-18 |
| 1063701951 | Nathan Ray Blecker | Surgery | Msc11 6093, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2011-03-31 |
| Find all providers with the same taxonomy | ||||
| City | RIO RANCHO |
| Zip Code | 87144 |
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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.