Provider Demographics
NPI:1194100644
Name:BENZEL, JAMES THOMAS (ATC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:THOMAS
Last Name:BENZEL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 CALIFORNIA PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68178-0002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:804-628-0048
Practice Address - Street 1:CREIGHTON UNIVERSITY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68178-2003
Practice Address - Country:US
Practice Address - Phone:402-880-0497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260022772255A2300X
NE11172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer