KENNETH BENTLEY (NPI# 1902879794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
R5N44 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 208845909 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326691015 | Kenneth Howard Bentley | Technician | 2820 W Charleston Blvd # A8, Las Vegas, NV 89102-1942 | 2019-07-22 |
Street Address |
12303 DEPAUL DR |
City | BRIDGETON |
State | MO |
Zip Code | 63304 |
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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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 |
Find all providers in zip 63304 |
Taxonomy Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
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. |
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 |
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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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.