Individual provider Active NPI

Annie Bentley, APRN

  • Family Nurse Practitioner
  • London, KY
National Provider Identifier
1447807045
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013527 Issued in KY
Practice address
803 Meyers Baker Rd Ste 200
London, KY 40741-3040
Phone
(606) 878-3240
Fax
(606) 878-3245
NPI assigned
Aug 20, 2019
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3013527 KY Primary

Addresses

Primary practice location

803 Meyers Baker Rd Ste 200
London, KY 40741-3040

Mailing address

509 Memorial Dr Ste 2
Manchester, KY 40962-6196
Phone (606) 598-5104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20191119002091 KY Practitioner - Nurse Practitioner 1355773078 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
London Women's Care LLCGroup PAC ID 6204721566, 37 clinicians

Practice addresses (Care Compare)

803 Meyers Baker Rd
Suite 200
London, KY 40741-3040
Phone (606) 878-3240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3013527KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc. Family CurrentSince Oct 1, 2019 Accepting new patients
Memorial Hospital, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Memorial Hospital, Inc. Family Current Accepting new patients
Memorial Hospital, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Memorial Hospital, Inc. Family CurrentSince Oct 1, 2019 Accepting new patients

Locations

1033 N Highway 11
Manchester, KY 40962
Phone (606) 598-6163

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

509 Memorial Dr
Ste 2
Manchester, KY 40962
Phone (606) 598-4384

53 Queendale Ctr
Red Bird, KY 40913
Phone (606) 598-5135

Interoperability endpoints

  • Direct secure messaging: anniebentley@lwc.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1447807045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MEMORIAL DR STE 2",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626196",
            "telephone_number": "606-598-5104",
            "fax_number": "606-598-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 MEYERS BAKER RD STE 200",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407413040",
            "telephone_number": "606-878-3240",
            "fax_number": "606-878-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "ANNIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.