David E Bellville, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA227 Issued in KY

Practice address

2025 Carter Ave
Ashland, KY 41101-7731

Phone

(606) 408-4900

Fax

(606) 408-2749

NPI assigned

Dec 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1316002199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "address_2": "PO BOX 1595",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 CARTER AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017731",
            "telephone_number": "606-408-4900",
            "fax_number": "606-408-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLVILLE",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA227",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "002898",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "683",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95000659",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• Ben J. O'Dell, MD, PSC
• Jamie Bennett
• Kayla Ambria Bennett, PTA
• Tracy Bentley
• Alynn Ann Berg

• All providers in Ashland, KY
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.