DR. MICHAEL GEORGE BENNE JR. (NPI# 1982786471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982786471 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL GEORGE BENNE JR. |
| Credential | MD |
| Practice Address |
504 Nw 10th Ave. Ava MO 65608 |
| Mailing Address |
Po Box 1359 Ava MO 65608 |
| Practice Telephone | 4176834831 |
| Practice Fax Number | 4176831602 |
| Mailing Telephone | 4176834831 |
| Mailing Fax Number | 4176831602 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2009-12-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | MD0000034580 | TN | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 2009035422 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS OF TN | 4120779 | 01 |
| TN | 3337428 | 05 |
| Street Address |
504 NW 10TH AVE. |
| City | AVA |
| State | MO |
| Zip Code | 65608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841283868 | Ida N Junge | Nurse Practitioner | 504 Nw 10th Ave., Ava, MO 65608-1359 | 2005-08-24 |
| 1487210969 | Shari Ranee Cook | Nurse Practitioner | 504 Nw 10th Ave., Ava, MO 65608 | 2019-05-10 |
| 1548444516 | Kammi L Grosse | Dental Hygienist | 504 Nw 10th Ave., Ava, MO 65608 | 2007-12-26 |
| 1992896997 | Ivy Lenarz | Social Worker | 504 Nw 10th Ave., Ava, MO 65608-1359 | 2006-09-27 |
| 1700980174 | Michael David Ball | Family Medicine | 504 Nw 10th Ave., Ava, MO 65608-1359 | 2006-09-07 |
| 1326158957 | Douglas County Public Health Services Group, Inc. | Pharmacy | 504 Nw 10th Ave., Ava, MO 65608 | 2006-08-30 |
| 1508801580 | Holli K Ruby | Family Medicine | 504 Nw 10th Ave., Ava, MO 65608-1359 | 2006-06-16 |
| 1073587168 | Martin R. Sevrey Jr. | Family Medicine | 504 Nw 10th Ave., Ava, MO 65608-1359 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306326871 | Regional Services | Nurse Practitioner | 507 Ne 3rd St, Ava, MO 65608 | 2018-08-15 |
| 1629558168 | Smith Management Services, LLC | Durable Medical Equipment & Medical Supplies | 916 N.w. Springfield Ave, Suite F, Ava, MO 65608 | 2018-08-15 |
| 1235639592 | Carolyn Marie Myers | Occupational Therapist | 223 South Jefferson Street, Ava, MO 65608 | 2018-02-13 |
| 1114386497 | Judy King | Counselor | 202 Nw Str Str 1, Ava, MO 65608 | 2016-02-16 |
| 1548653009 | Grace Smith | Pharmacist | 124 West Washington Avenue, Ava, MO 65608 | 2015-03-09 |
| 1427397769 | Rebecca L Mcbride | Nurse Practitioner | 120 W Lincoln Ave, Ava, MO 65608 | 2013-02-06 |
| 1154695716 | Medical Equipment Inspection & Repair | Durable Medical Equipment & Medical Supplies | 122 East Washington Ave, Ava, MO 65608 | 2012-02-29 |
| 1932471695 | Lacinda Kaye Higley | Mechanotherapist | 603 North West 10th Ave, Ava, MO 65608 | 2012-01-27 |
| 1972812592 | Douglas County Public Health Services Group, Inc. | Clinic/Center | 603 Nw 10th Ave., Ava, MO 65608 | 2010-09-30 |
| 1013224047 | Family Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 916 N.w. 12th Ave, Suite F, Ava, MO 65608 | 2010-09-13 |
| Find all providers in zip 65608 | ||||
| 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 |
|---|---|---|---|---|
| 1053481689 | Regional Services | Family Medicine | 806 Sw Collins Avenue, Ava, MO 65608 | 2006-11-09 |
| 1942390695 | Lester E. Cox Medical Centers | Family Medicine | 806 Sw 13th Ave, Ava, MO 65608 | 2006-10-13 |
| 1700986270 | Augusta Ellice Hays | Family Medicine | 504 W. Broadway Ave., Ava, MO 65608-1359 | 2006-09-25 |
| 1598863896 | Christine Gentry | Family Medicine | 806 Sw Collins Ave, Ava, MO 65608-5532 | 2006-09-20 |
| 1770618233 | Mercy Clinic Springfield Communities | Family Medicine | 1312 North Highway 5, Ava, MO 65608 | 2007-02-23 |
| 1700980174 | Michael David Ball | Family Medicine | 504 Nw 10th Ave., Ava, MO 65608-1359 | 2006-09-07 |
| 1508801580 | Holli K Ruby | Family Medicine | 504 Nw 10th Ave., Ava, MO 65608-1359 | 2006-06-16 |
| 1073587168 | Martin R. Sevrey Jr. | Family Medicine | 504 Nw 10th Ave., Ava, MO 65608-1359 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596877 | Stephanie R Nicholson | Family Medicine | 4500 S Park Ave, Sedalia, MO 65301-8525 | 2020-10-21 |
| 1053919514 | Kelli Lichte | Family Medicine | 601 S 13 Hwy, Lexington, MO 64067-1511 | 2020-10-15 |
| 1053927228 | Cox- Monett Hospital, Inc. | Family Medicine | 1000 E Hwy 60, Monett, MO 65708 | 2020-09-22 |
| 1104432806 | Jefferson Medical Group | Family Medicine | 807 E Broadway St, Brunswick, MO 65236-1468 | 2020-09-17 |
| 1124633995 | Continuum Family Care LLC | Family Medicine | 2336 S Main St, Maryville, MO 64468-3622 | 2020-09-09 |
| 1326652579 | Linda Diane Watson | Family Medicine | 338 Emerson Rd Apt 104, High Ridge, MO 63049-2530 | 2020-09-04 |
| 1447868005 | Brittany Mechelle Waterworth | Family Medicine | 3700 I 70 Dr Se Ste 106, Columbia, MO 65201-6587 | 2020-07-20 |
| 1013542828 | Johns Healthcare Services LLC | Family Medicine | 2001 Independence St Ste A, Cape Girardeau, MO 63703-5805 | 2020-03-12 |
| 1972133460 | Fnp4jc, LLC | Family Medicine | 215 North Street, Waynesville, MO 65583 | 2020-01-23 |
| 1568092732 | Scotland County Memorial Hospital | Family Medicine | 55682 State Highway 6, Edina, MO 63537-4267 | 2020-01-16 |
| Find all providers with the same taxonomy | ||||
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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.