JACOB ERIC BENTLEY (NPI# 1417127432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417127432 |
| Entity Type | Individual |
| Full Name | JACOB ERIC BENTLEY |
| Credential | CO, LO |
| Practice Address |
127 Enterprise Path Ste 403 Hiram GA 30141-2697 |
| Mailing Address |
1619 John Orr Dr Tifton GA 31794-3640 |
| Practice Telephone | 6783841921 |
| Practice Fax Number | 6783841922 |
| Mailing Telephone | 2293869829 |
| Mailing Fax Number | 2293869830 |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2011-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | 14 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803701 | Jacob Michael Bentley | Counselor | 3712 Middlebrook Pike, Knoxville, TN 37921-6503 | 2020-02-18 |
| 1023261831 | Jacob A Bentley | Psychologist | 5601 Loch Raven Blvd, Pob 406, Baltimore, MD 21239-2945 | 2008-10-24 |
| Street Address |
127 ENTERPRISE PATH STE 403 |
| City | HIRAM |
| State | GA |
| Zip Code | 30141-2697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760622294 | Accumed Home Health Services of Georgia, Inc | Home Health | 127 Enterprise Path, Suite 406, Hiram, GA 30141-2697 | 2009-02-24 |
| 1699945154 | South Gaorthopedic Resources | Durable Medical Equipment & Medical Supplies | 127 Enterprise Path, Ste 403, Hiram, GA 30141-2697 | 2008-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801255690 | Belinda Lett Baker | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5316 Jones Reserve Walk, Hiram, GA 30141 | 2016-02-22 |
| 1104213339 | Matthew Lee Estes | Nurse Practitioner | 148 Bill Carruth Pkwy Ste 220, Hiram, GA 30141 | 2015-04-26 |
| 1881088649 | Marietta Eye Clinic, Pa | Optometrist | 47 Highland Pavilion Ct, Suite 101, Hiram, GA 30141 | 2015-03-19 |
| 1902217417 | Hiram Dental Group, PC | Dentist | 5218 Jimmy Lee Smith Parkway, Suite 100, Hiram, GA 30141 | 2014-05-19 |
| 1912340613 | Anuj Patel | Orthopaedic Surgery | 148 Bill Carruth Parkway Suite 120, Hiram, GA 30141 | 2013-04-11 |
| 1619280278 | Thomas Wayne Bloodworth | Obstetrics & Gynecology | 6794 Bill Carruth Parkway, Hiram, GA 30141 | 2010-07-23 |
| 1487970026 | Madelynn Lorraine Speach | Counselor | 44 Darbys Crossing Dr Ste 206c, Hiram, GA 30141 | 2010-04-07 |
| 1679760433 | We Care Md, P.C. | Family Medicine | 5610 Wendy Bagwell Parkway, Suite 103, Hiram, GA 30141 | 2007-09-26 |
| 1811188121 | Holly L Watson | Nurse Practitioner | 156 Hiram Drive, Building B, Hiram, GA 30141 | 2007-08-05 |
| 1285842799 | Restoration Physical Therapy, LLC. | Clinic/Center | 5077 Jimmy Lee Smith Pkwy, Suite 119, Hiram, GA 30141 | 2007-05-18 |
| Find all providers in zip 30141 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700412517 | Delana Finney | Orthotist | Vamc - Atlanta, 1670 Clairmont Rd, Decatur, GA 30033 | 2020-03-13 |
| 1265938716 | James Maurice Barnes | Orthotist | 6355 Peachtree Dunwoody Rd Apt 309, Sandy Springs, GA 30328-4627 | 2018-04-03 |
| 1023543246 | Eric Chen | Orthotist | 61 Whitcher St Ne Ste 2120, Marietta, GA 30060-1180 | 2017-04-25 |
| 1336572403 | Edward Gurin | Orthotist | 10985 Chandon Way, Johns Creek, GA 30097-7859 | 2013-08-13 |
| 1528308319 | Susan Grogan Semmes | Orthotist | 404 Northside Dr, Ste D, Valdosta, GA 31602-1866 | 2013-02-15 |
| 1235437187 | Kimberly Kathleen Hill | Orthotist | 598 Sweetfern Ln, Sugar Hill, GA 30518-7613 | 2011-03-02 |
| 1528216892 | Milton Renard Reed | Orthotist | 1810 Mulkey Rd Ste 202, Austell, GA 30106-1150 | 2008-08-28 |
| 1659533446 | Alphonso Bryant | Orthotist | 182 Riley Ave, Ste. B, Macon, GA 31204-0771 | 2008-07-02 |
| 1629251491 | Benjamin Valer Valena | Orthotist | 3783 Presidential Pkwy, Ste 112, Atlanta, GA 30340-3709 | 2007-12-14 |
| 1518167147 | Ivan Ruiz | Orthotist | 9690 Vantana Way, Johns Creek, GA 30022-6394 | 2007-07-22 |
| 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.