Individual provider Active NPI

Terry Wayne Bentley, M.D.

  • Psychiatry Physician
  • Jasper, AL
National Provider Identifier
1508933003
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
00016128 Issued in AL
Practice address
20 Medical Center Dr Ste 300
Jasper, AL 35501-3428
Phone
(205) 384-0141
Fax
(205) 384-0171
NPI assigned
Nov 29, 2006
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 16128 AL
Psychiatry Physician 2084P0800X 00016128 AL Primary

Addresses

Primary practice location

20 Medical Center Dr Ste 300
Jasper, AL 35501-3428

Mailing address

20 Medical Center Dr Ste 300
Jasper, AL 35501-3428
Phone (205) 384-0141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080623000483 AL Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 1759452568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
University of Alabama School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 Medical Ctr Dr
Suite 300
Jasper, AL 35501-3428
Phone (205) 384-0141

20 Medical Ctr Dr
Suite 300
Jasper, AL 35549-3428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00016128ALMDPsychiatry Physician
16128ALMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Alabama Psychiatric Services Current Accepting new patients
Northwest Alabama Psychiatric Services Psychiatry CurrentSince Jan 1, 1996 Accepting new patients

Locations

20 Medical Center Dr
Ste 300
Jasper, AL 35501
Phone (205) 384-0141

3400 Highway 78 E
Ste 200
Jasper, AL 35501
Phone (205) 384-0141

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1508933003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL CENTER DR STE 300",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355013428",
            "telephone_number": "205-384-0141",
            "fax_number": "205-384-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL CENTER DR STE 300",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355013428",
            "telephone_number": "205-384-0141",
            "fax_number": "205-384-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "TERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "16128",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "00016128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

Verify at the official NPI Registry.