Charles Henry Bentlage, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27302 Issued in MO

Practice address

4301 Doniphan Dr
Neosho, MO 64850-9120

Phone

(417) 451-9450

NPI assigned

Apr 30, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 37

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 38

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Ozark Tri County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1376582346

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Diamond, MO
  • NPI 1003573015

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Neosho, MO
  • NPI 1013368984

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Pineville, MO
  • NPI 1063178341

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Neosho, MO
  • NPI 1114626652

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Neosho, MO
  • NPI 1134828676

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Neosho, MO
  • NPI 1134828692

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Pineville, MO
  • NPI 1134886005

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Cassville, MO
  • NPI 1205886769

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1215696976

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Anderson, MO
  • NPI 1265428791

  Corporate Director

  CMS ownership
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1295908911

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ozark Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Joplin, MO
  • NPI 1790796878

  MO

  Medicare reassignment NPD
• Ozark Center

  • Behavior Analyst
  • Joplin, MO
  • NPI 1790038511

  Family Medicine

  NPD
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Carthage, MO
  • NPI 1992995120
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272585600000",
    "number": "1033436902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 DONIPHAN DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648509120",
            "telephone_number": "417-451-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 DONIPHAN DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648509120",
            "telephone_number": "417-451-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLAGE",
        "first_name": "CHARLES",
        "middle_name": "HENRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-30",
        "last_updated": "2010-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "27302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Antwiler
• Grace Bailey, SLP
• Larry G Barnes, MD
• Samantha Beall, M.S., CCC-SLP
• Cameron Belmore, COTA/L
• Kimberly A. Benton, DC
• Matthew P. Benton, D.C.
• Big Tree Medical Neosho
• Bio-Medical Applications of Missouri, Inc.
• Bioethics Solutions, Inc.

• All providers in Neosho, MO
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.