BENJAMIN PARK (NPI# 1144239740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144239740 |
| Entity Type | Individual |
| Full Name | BENJAMIN PARK |
| Credential | M.D. |
| Practice Address |
194 Missile Ave Minot Afb ND 58705 |
| Practice Telephone | 7017235100 |
| Mailing Telephone | 7017235100 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 01062522A | IN | Allopathic & Osteopathic Physicians |
| Y | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
01062522A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124393558 | Benjamin Park | Internal Medicine | 1600 Clifton Rd Ne # Msc09, Atlanta, GA 30329-4018 | 2012-03-19 |
| 1992267587 | Benjamin Park | Student in an Organized Health Care Education/Training Program | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2019-04-02 |
| 1770922676 | Benjamin Ross Park | Radiology | 1650 Cochrane Cir # B7500, Fort Carson, CO 80913 | 2013-06-24 |
| 1205121639 | Benjamin L Park | Anesthesiology | 100 Hospital Ave, Du Bois, PA 15801-1440 | 2011-06-14 |
| Street Address |
194 MISSILE AVE |
| City | MINOT AFB |
| State | ND |
| Zip Code | 58705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194759126 | Brianne Newman | Dietitian, Registered | 194 Missile Ave, 5 Mdg, Minot Afb, ND 58705-5024 | 2006-07-10 |
| 1316449705 | Erin Caroline | Dietitian, Registered | 194 Missile Ave, Minot Afb, ND 58704 | 2018-03-01 |
| 1689106320 | Priscilla Barrio | Student in an Organized Health Care Education/Training Program | 194 Missile Ave, Minot Afb, ND 58705 | 2017-03-31 |
| 1801201793 | 5th Medical Group | Pharmacy | 194 Missile Ave, Minot Afb, ND 58705-5008 | 2014-06-30 |
| 1184904237 | Deborah K Jones | Registered Nurse | 194 Missile Ave, Minot Afb, ND 58704 | 2011-08-22 |
| 1265731939 | Alexis Marie Paschal | Military Health Care Provider | 194 Missile Ave, Minot Afb, ND 58705-0000 | 2011-03-21 |
| 1205166881 | Melanie M. Johnson | Physician Assistant | 194 Missile Ave, Minot Afb, ND 58705 | 2010-01-05 |
| 1902028285 | Audra Dee Myers | Dentist | 194 Missile Ave, Minot Afb, ND 58705-5024 | 2007-05-03 |
| 1275601320 | Matthew Duane Graham | Family Medicine | 194 Missile Ave, Minot Afb, ND 58705 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265093900 | Coty Winn | Student in an Organized Health Care Education/Training Program | Minot Afb Medical Group, 194 Missile Avenue, Minot Afb, ND 58705 | 2019-06-24 |
| 1144717596 | Angela Kennedy | Social Worker | 5 Mdg 194 Missile Avenue, Minot Afb, ND 58705 | 2018-04-20 |
| 1386064780 | Desiree Avedon Aaron-barber | Licensed Practical Nurse | Minot Va Cboc, Minot Air Force Base, Minot, ND 58705 | 2014-04-24 |
| 1366771644 | Melanie Renee Roserie | Social Worker | 194 Missile Avenue, Minot Afb - 5 Mdg Mental Health Clinic, Minot, ND 58705 | 2009-12-15 |
| 1255565289 | Javier Alberto Padial | Pediatrics | 194 Missle Ave., Minot Afb, Apo, AA 58705 | 2009-05-05 |
| 1184694127 | Michelle Joy Fundingsland | Dietitian, Registered | 201 Missile Ave, Minot Afb, ND 58705 | 2006-01-24 |
| 1306404645 | Yongke Tan | Pharmacist | 194 Missile Avenue, Minot Afb, ND 58705 | 2019-06-02 |
| 1649605072 | Jared Jon Solomon | Psychiatry & Neurology | 10 Missile Ave, Minot Afb, ND 58705 | 2013-09-04 |
| 1881953602 | Casey Simon Brock | Physician Assistant | 194 Missile Avenue, Minot Air Force Base, ND 58705 | 2012-05-14 |
| 1518257187 | Edward Michael Schmitt | Family Medicine | 5th Medical Group, 194 Missile Ave, Minot Afb, ND 58705 | 2011-04-15 |
| Find all providers in zip 58705 | ||||
| Taxonomy Code | 2083A0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Aerospace Medicine |
| Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. |
| 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 Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811375520 | Farid Malof | Preventive Medicine | 1599 J St Rm 1013, Grand Forks Afb, ND 58205-6332 | 2015-05-13 |
| 1770686628 | Warren C Jensen | Preventive Medicine | Mccannel Hall, Room 100, 2891 2nd Avenue N., Stop 9038, Grand Forks, ND 58202-9038 | 2006-09-06 |
| 1952868606 | Amanda Ammentorp | Preventive Medicine | 1599 J St, Grand Forks Afb, ND 58205-6306 | 2019-02-28 |
| 1538548714 | Philip Cushman IIi | Preventive Medicine | 1599 J St, Grand Forks Afb, ND 58205-6306 | 2015-05-21 |
| 1114072303 | Gary Glenn Reams | Preventive Medicine | 1015 4th Ave S, Wishek, ND 58495-0617 | 2007-01-25 |
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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.