Active NPI
Gina M Bentley, RN
- Psychiatric/Mental Health Nurse Practitioner
- Johnson City, TN
National Provider Identifier
1053486274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- APN14084
- Practice address
- 109 W Watauga Ave
Watauga Behavioral Health Services
Johnson City, TN 37604 - Phone
- (423) 232-2600
- Fax
- (423) 232-2646
- NPI assigned
- Nov 22, 2006
- Last updated
- Apr 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APN14084 | TN | Primary |
| Registered Nurse | 163W00000X | RN87906 | TN |
Addresses
Primary practice location
109 W Watauga Ave
Watauga Behavioral Health Services
Johnson City, TN 37604
Mailing address
PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3600
Other names 1
- Gina M Houser
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN87906 | TN | MD | Registered Nurse |
| APN14084 | TN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renuven Health Partners of Georgia PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1871196519
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240185600000",
"number": "1053486274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9054",
"city": "GRAY",
"state": "TN",
"postal_code": "376159054",
"telephone_number": "423-467-3600",
"fax_number": "423-467-3696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 W WATAUGA AVE",
"address_2": "WATAUGA BEHAVIORAL HEALTH SERVICES",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "37604",
"telephone_number": "423-232-2600",
"fax_number": "423-232-2646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "GINA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2009-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TN",
"license": "APN14084",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "RN87906",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GINA",
"last_name": "HOUSER",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.