NPIMap

Organization Active NPI

Robert J. Bentley LLC

Doing business as Dermatology Care of Alabama

  • Dermatology Physician
  • Tuscaloosa, AL
National Provider Identifier
1366970253
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
5543 Issued in AL
Legal business name
ROBERT J. BENTLEY LLC
Doing business as
Dermatology Care of Alabama
Practice address
900 Veterans Memorial Pkwy
Tuscaloosa, AL 35404-5848
Phone
(205) 759-1519
NPI assigned
May 23, 2017
Last updated
May 23, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ROBERT J.BENTLEY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Authorized official

Name
Dr. Robert Bentley, MDNPI 1548201544
Title
Owner/Physician
Phone
(205) 759-1519

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 5543 AL Primary

Addresses

Primary practice location

900 Veterans Memorial Pkwy
Tuscaloosa, AL 35404-5848

Mailing address

900 Veterans Memorial Pkwy
Tuscaloosa, AL 35404-5848

Other names 1

  • Dermatology Care of Alabama Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170703000520 AL Part B Supplier - Clinic/Group Practice 5799054904 Receives reassigned benefits from 8 practitioners
Practice locations: Tuscaloosa, AL

National Provider Directory

National Provider Directory
Part of
Robert J Bentley LLC

Locations

2321 John Hawkins Pkwy
Ste 201
Hoover, AL 35244
Phone (205) 379-8389

2321 John Hawkins Pkwy
Ste 401
Hoover, AL 35244

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

900 Veterans Memorial Pkwy
Tuscaloosa, AL 35404
Phone (205) 759-1519

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495497600000",
    "number": "1366970253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VETERANS MEMORIAL PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 VETERANS MEMORIAL PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045848",
            "telephone_number": "205-759-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J. BENTLEY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROBERT J.BENTLEY LLC",
        "enumeration_date": "2017-05-23",
        "last_updated": "2017-05-23",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "205-759-1519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "5543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Care of Alabama",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.