Jessica Jane Bentley, CNM
Individual provider Active NPI Advanced Practice Midwife · Bolivia, NC
NPI 1194222869 · NPPES record last updated Jul 8, 2022
Key facts
- NPI
- 1194222869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- License
- 825 (NC)
- Practice address
- 584 Hospital Dr NE Unit B
Bolivia, NC 28422-0020 - Phone
- (910) 721-4050
- Fax
- (910) 721-4051
- NPI assigned
- Apr 10, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220609002760 | NC | Practitioner - Certified Nurse Midwife (CNM) | 8820476484 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21787 | SC | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group LLC | Current |
Accepting new patients | |
| Novant Health Medical Group, LLC | Current |
Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients |
Locations
584 Hospital Dr NE
Unit B
Bolivia, NC 28422
Phone (910) 662-9480
75 Emerson Bay Rd
Ste 104
Carolina Shores, NC 28467
Phone (910) 667-4283
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- jbentley98963@direct.novanthealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 21787 | SC | |
| Advanced Practice Midwife | 367A00000X | 825 | NC | Yes |
Addresses
Primary practice location
584 Hospital Dr NE Unit B
Bolivia, NC 28422-0020
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
1007 N Fraser St
Georgetown, SC 29440-2848
Phone (843) 527-4343
Other practice location 2
4017 Highway 17
Murrells Inlet, SC 29576-5032
Phone (843) 651-6525 ext. 5098
Other providers in Bolivia, NC
- Kevin Arthur Applegate
- Alexander Arbelo Ramos
- Anita Bakula
- Benchmark Physical Therapy of NC, LLC
- Matt Aaron Benenati
- Angeline McCormick Bertsch
- Kenya Bethea
- Pamela Ann Betz
- Hussain Khuzem Bhagat
- Chandana Bhimmanapalli
All providers in Bolivia, NC · Advanced Practice Midwife in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.