Active NPI
Joan N Bentley, FNP
- Family Nurse Practitioner
- West Jordan, UT
National Provider Identifier
1467485342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 176931-4405
- Practice address
- 3570 W 9000 S Ste 200
West Jordan, UT 84088-8875 - Phone
- (801) 566-9211
- Fax
- (801) 566-5667
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 176931-4405 | UT | Primary |
Addresses
Primary practice location
3570 W 9000 S Ste 200
West Jordan, UT 84088-8875
Mailing address
3570 W 9000 S Ste 200
West Jordan, UT 84088-8875
Phone (801) 566-9211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07159 | Medicaid | UT |
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 176931-4405 | UT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467485342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3570 W 9000 S STE 200",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840888875",
"telephone_number": "801-566-9211",
"fax_number": "801-566-5667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3570 W 9000 S STE 200",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840888875",
"telephone_number": "801-566-9211",
"fax_number": "801-566-5667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "JOAN",
"middle_name": "N",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "176931-4405",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07159",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.