Individual provider Active NPI

James Lewis Fenley III

  • Nurse Practitioner
  • Tuscaloosa, AL
National Provider Identifier
1124667332
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1167245 Issued in AL
Practice address
4960 Rice Mine Rd NE Ste 40
Tuscaloosa, AL 35406-3136
Phone
(205) 759-1519
Fax
(205) 750-8612
NPI assigned
Jan 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1167245 AL Primary

Addresses

Primary practice location

4960 Rice Mine Rd NE Ste 40
Tuscaloosa, AL 35406-3136

Mailing address

1627 River Ro Dr
Tuscaloosa, AL 35406-2396
Phone (478) 363-9399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221013003735 AL Practitioner - Nurse Practitioner 9234505322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert J Bentley LLCGroup PAC ID 5799054904, 7 clinicians

Practice addresses (Care Compare)

4960 Rice Mine Rd NE
Suite 40
Tuscaloosa, AL 35406-3136
Phone 2057591519102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1167245ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert J. Bentley LLC CurrentSince Jul 8, 2022 Accepting new patients
Robert J. Bentley LLC CurrentSince Jul 8, 2022 Accepting new patients

Locations

4960 Rice Mine Rd NE
Ste 40
Tuscaloosa, AL 35406
Phone (205) 759-1519

Interoperability endpoints

  • Direct secure messaging: trey@dermcareal.emadirect.md

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1124667332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 RIVER RO DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062396",
            "telephone_number": "478-363-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 RICE MINE RD NE STE 40",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063136",
            "telephone_number": "205-759-1519",
            "fax_number": "205-750-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENLEY",
        "first_name": "JAMES",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1167245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.