Healthcare Provider Details

I. General information

NPI: 1144643875
Provider Name (Legal Business Name): CODY JON BENSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3335 W WOOD RIVER RD SUITE B
GRAND ISLAND NE
68803-9117
US

IV. Provider business mailing address

3335 W WOOD RIVER RD SUITE B
GRAND ISLAND NE
68803-9117
US

V. Phone/Fax

Practice location:
  • Phone: 402-741-1451
  • Fax: 308-382-9276
Mailing address:
  • Phone: 402-741-1451
  • Fax: 308-382-9276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1779
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number1779
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number3435763523
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: