Individual provider Active NPI

Jessica Anne Bentson, DPM

  • Podiatrist
  • Bismarck, ND
National Provider Identifier
1386654424
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
49 Issued in ND
Practice address
525 N 9TH St
Bismarck, ND 58501-4510
Phone
(701) 258-8120
Fax
(701) 222-0229
NPI assigned
Aug 9, 2006
Last updated
Oct 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 49 ND Primary

Addresses

Primary practice location

525 N 9TH St
Bismarck, ND 58501-4510

Mailing address

525 N 9TH St
Bismarck, ND 58501-4510
Phone (701) 258-8120

Other identifiers 1

IdentifierTypeStateIssuer
12003MedicaidND

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

State licenses

LicenseStateTypeSpecialty
782MNMDMarriage & Family Therapist
49NDMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Maplewood Podiatry, LLC Podiatrist Past Accepting new patients
Family Foot & Ankle Clinic PC Past Accepting new patients

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, 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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1386654424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014510",
            "telephone_number": "701-258-8120",
            "fax_number": "701-222-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014510",
            "telephone_number": "701-258-8120",
            "fax_number": "701-222-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTSON",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ND",
            "license": "49",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12003",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.