Individual provider Active NPI

Gregory N. Bentzel, DPM

  • Podiatrist
  • Greer, SC
National Provider Identifier
1104885011
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
70 Issued in SC
Practice address
105 Mimosa Dr
Greer, SC 29650-1737
Phone
(864) 879-3888
Fax
(864) 801-3272
NPI assigned
Mar 20, 2006
Last updated
Dec 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 70 SC Primary

Addresses

Primary practice location

105 Mimosa Dr
Greer, SC 29650-1737

Mailing address

PO Box 1958
Greer, SC 29652-1958
Phone (864) 879-3888

Other identifiers 1

IdentifierTypeStateIssuer
PD0706MedicaidSC

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1104885011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1958",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296521958",
            "telephone_number": "864-879-3888",
            "fax_number": "864-801-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MIMOSA DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501737",
            "telephone_number": "864-879-3888",
            "fax_number": "864-801-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTZEL",
        "first_name": "GREGORY",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "70",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD0706",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.

Verify at the official NPI Registry.