KENNETH BENTLEY


Address: 12303 Depaul Dr, Bridgeton, MO 63304
Phone: 3143446000

KENNETH BENTLEY (NPI# 1902879794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902879794
Entity Type Individual
Full Name KENNETH BENTLEY
Credential M.D.
Practice Address 12303 Depaul Dr
Bridgeton
MO 63304
Mailing Address 999 Executive Parkway Dr
Suite 210
Saint Louis
MO 63141-6336
Practice Telephone 3143446000
Practice Fax Number 3145146020
Mailing Telephone 3145146000
Mailing Fax Number 3145146020
Enumeration Date 2006-02-10
Last Update Date 2011-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
R5N44 MO Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MO 208845909 05

Other Providers KENNETH BENTLEY

NPI Name Taxonomy Address Enumeration
1326691015 Kenneth Howard Bentley Technician 2820 W Charleston Blvd # A8, Las Vegas, NV 89102-1942 2019-07-22

Office Location

Street Address 12303 DEPAUL DR
City BRIDGETON
State MO
Zip Code 63304

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720078884 Nand K Kodwani Anesthesiology 12303 Depaul Dr, Bridgeton, MO 63044 2005-10-28
1366923187 Danielle Ann Hull Social Worker 12303 Depaul Dr, Bridgeton, MO 63044 2018-08-29
1770006405 Kayla Dawn Hoffmeister Speech-Language Pathologist 12303 Depaul Dr, 1639, Bridgeton, MO 63044 2017-07-25
1346773348 Leslie Joseph Podiatrist 12303 Depaul Dr, Bridgeton, MO 63044-2727 2017-04-06
1154866630 Stephanie Timko Counselor 12303 Depaul Dr, Bridgeton, MO 63044 2016-12-20
1902226418 James Ford Nurse Anesthetist, Certified Registered 12303 Depaul Dr, Bridgeton, MO 63044-2512 2014-04-23
1932528973 Michelle Lee Plank Registered Nurse 12303 Depaul Dr, Bridgeton, MO 63044 2014-04-07
1811334659 Rebecca Palas Social Worker 12303 Depaul Dr, Bridgeton, MO 63044 2013-06-03
1902172521 Deborah A Monje Dietitian, Registered 12303 Depaul Dr, Bridgeton, MO 63044-2588 2012-03-28
1396019840 Taren Ashley Rutz Nurse Anesthetist, Certified Registered 12303 Depaul Dr, Bridgeton, MO 63044-2512 2012-03-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699382127 Susan Brockmeyer Occupational Therapist 600 Breeze View Ln, Weldon Springs, MO 63304 2020-09-29
1235743097 Brett Allan Lancaster Pharmacist 3801 Old Highway 94, St. Peters, MO 63304 2020-08-31
1356834683 Emily Elizabeth Blau Chiropractor 5055 State Highway N, 108, Cottleville, MO 63304 2018-06-12
1033606769 Christina Marie Crain Counselor 501 Chele Dr, Saint Charles, MO 63304 2018-04-18
1063875532 Amy L Ney-carder Speech-Language Pathologist 5199 State Highway N, St. Peters, MO 63304 2016-04-01
1609127745 Lawlor Chiropractic LLC Chiropractor 6028 Weldon Spring Parkway, Weldon Spring, MO 63304 2012-09-28
1043588510 Esther Lima Pharmacist 3801 S Harvester Rd, St Peters, MO 63304 2011-12-12
1922318245 Sonya Paramore Counselor 1480 Woodstone Drive, Suite 211, Saint Charles, MO 63304 2010-10-20
1871624445 Joylynn Anderson Social Worker 5931 Highway 94 South, Saint Charles, MO 63304 2007-03-08
1821155706 Cynthia Lynn Sitarski Occupational Therapist 4545 Central School Road, St. Charles, MO 63304 2007-01-02
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Taxonomy Information

Taxonomy Code 207RC0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Critical Care Medicine

Taxonomy Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386642320 Sameer Rana Internal Medicine 12303 Depaul Drive, Bridgeton, MO 63044 2005-07-13
1013178235 Ashfaq Ullah Internal Medicine 12255 De Paul Dr Ste 500, Bridgeton, MO 63044-2515 2008-06-19
1962591222 Parneeta H. Bhatia Internal Medicine 12303 De Paul Dr, Bridgeton, MO 63044-2512 2006-10-12
1629096359 Michael J Walter Internal Medicine 12303 Depaul Dr, Bridgeton, MO 63044 2006-07-18
1225001951 Gary Behrens Internal Medicine 12303 De Paul Dr, Bridgeton, MO 63044-2512 2006-02-13
1972576775 Mary Jo Gorman Internal Medicine 12303 Depaul Drive, Bridgeton, MO 63044-5536 2006-02-10
1407829203 Dellice Dickhaus Internal Medicine 12303 Depaul Drive, Bridgeton, MO 63141 2006-02-10
1922071729 Francis Ntimba Internal Medicine 12303 Depaul Drive, Bridgeton, MO 63044 2006-02-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1255641684 Ashwin Mani Internal Medicine 999 Executive Parkway, Ste 210, St. Louis, MO 63141 2010-10-19
1275845208 Jimmy L Moss Internal Medicine 12634 Olive Blvd Dept Of, Saint Louis, MO 63141-6337 2010-07-07
1124215124 Aravind Pothineni Internal Medicine 1723 Broadway Suite 205, Cape Giradeau, MO 63701 2007-10-03
1023202736 Branson Pulmonology LLC Internal Medicine 545 Branson Landing Blvd Ste 301, Branson, MO 65616-4055 2007-09-05
1982618856 Mahmoud Mohamad Ali El-sayed Internal Medicine 1300 Turtle Cv, Ballwin, MO 63011-4249 2006-07-28
1689602930 Sohail Khan Internal Medicine 1111 Mcintosh Cir Ste 302, Joplin, MO 64804-3693 2006-06-28
1154360550 Nikhat Salamat Internal Medicine 727 Craig Rd, Suite 101, Creve Coeur, MO 63141-7175 2006-06-04
1558309898 John R. Carlile Internal Medicine 1000 E. Primrose, #200, Springfield, MO 65807-5388 2006-06-02
1710933825 Adeel Pervez Internal Medicine 4911 S Arrowhead Dr Ste 201, Independence, MO 64055-7008 2006-05-26
1154389336 Patrick B Sandiford Internal Medicine 201 First Executive Ave, St Peters, MO 63376-1697 2006-05-03
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Competitor

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City BRIDGETON
Zip Code 63304

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Dataset Information

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.

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