Fred A. Benjamin Iv, CRNA
NPI 1063404036ActiveIndividual· Registered Nurse· Jackson, TN
Registered Nurse (CRNA) in Jackson, Tennessee, licensed in TN, with an NPI issued in August 2005.
Overview
| NPI | 1063404036 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CRNA |
| Sole proprietor | No |
| NPI issued | Aug 16, 2005 |
| Last updated in NPPES | Jul 13, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Registered Nurse Primary | 163W00000X | RN0000085124 | TN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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