Individual provider Active NPI

Anthony J Bentley, D.C.

  • Chiropractor
  • Middletown, OH
National Provider Identifier
1568460582
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2756 Issued in OH
Practice address
4421 Roosevelt Blvd
Suite B
Middletown, OH 45044-6239
Phone
(513) 423-0550
Fax
(513) 423-5171
NPI assigned
Jul 13, 2005
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2756 OH Primary

Addresses

Primary practice location

4421 Roosevelt Blvd
Suite B
Middletown, OH 45044-6239

Mailing address

3630 Commerce Dr
Middletown, OH 45005-5228
Phone (513) 423-0550

Other identifiers 4

IdentifierTypeStateIssuer
2092471MedicaidOH
311733056-00OtherOHBWC PROVIDER#
000000179781OtherOHANTHEM PROVIDER#
31-1733056OtherOHTAX ID#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000731 OH Practitioner - Chiropractic 0244312700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3630 Commerce Dr
Middletown, OH 45005-5228
Phone (513) 423-0550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2756OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Reed Chiropractic Center, Inc. Chiropractor CurrentSince Dec 11, 2011 Accepting new patients
Bentley Chiropractic Center, Inc. Chiropractor CurrentSince Oct 1, 2000 Accepting new patients

Locations

3630 Commerce Dr
Middletown, OH 45005
Phone (513) 423-0550

4421 Roosevelt Blvd
Ste B
Middletown, OH 45044
Phone (513) 423-0550

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1568460582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 COMMERCE DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055228",
            "telephone_number": "513-423-0550",
            "fax_number": "513-423-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 ROOSEVELT BLVD",
            "address_2": "SUITE B",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450446239",
            "telephone_number": "513-423-0550",
            "fax_number": "513-423-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2092471",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC PROVIDER#",
            "identifier": "311733056-00",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER#",
            "identifier": "000000179781",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "31-1733056",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.