IndividualActive
Fred Benjamin IV, CRNA
NPI 1063404036 · Registered Nurse · Jackson, TN
Fred Benjamin IV, CRNA is a Registered Nurse provider in Jackson, TN (NPI 1063404036).
Provider details
- NPI number
- 1063404036
- Entity type
- Individual
- Primary specialty
- Registered NurseNursing Service Providers
- Credential
- CRNA
- Sex
- Male
- License
- RN0000085124 (TN)
Specialties & taxonomies
Nursing Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
36 Brentshire Sq
Jackson, TN 38305-2245
Phone: (731) 664-1717
Fax: (731) 664-7114
Street-level locationGet directions
Mailing address
70 State Route 420
Humboldt, TN 38343-5619
Registry dates
- Enumerated
- 2005-08-16
- Last updated
- 2007-07-08
Frequently asked questions
- What is Fred Benjamin IV's NPI number?
- Fred Benjamin IV's National Provider Identifier (NPI) is 1063404036, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Fred Benjamin IV's specialty?
- Fred Benjamin IV is listed in the NPPES registry with a primary specialty of Registered Nurse (Nursing Service Providers).
- Where is Fred Benjamin IV located?
- Fred Benjamin IV's practice location on file with NPPES is 36 Brentshire Sq, Jackson, TN 38305-2245.
- What is Fred Benjamin IV's phone number?
- The practice phone number listed in the NPPES registry for Fred Benjamin IV is (731) 664-1717.
- Is Fred Benjamin IV's NPI active?
- Yes — Fred Benjamin IV's NPI (1063404036) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.