Micca Lyn Bentley, FNP-C

Key facts

NPI

1609669308

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

53-84308-062 (KS)

Practice address

822 N Andover Rd
Andover, KS 67002-9527

Phone

(316) 247-5499

Fax

(316) 351-5965

NPI assigned

May 26, 2025

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Tanglewood Family Medical Center PA Family Medicine Physician · Derby, KS · NPI 1659472306
  Medicare reassignment Care Compare group KS
• Medical on Demand LLC Family Medicine Physician · Wichita, KS · NPI 1518618958
  NPD (past)

Hospital & facility affiliations 1

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

• Kansas Medical Center LLC General Acute Care Hospital · Andover, KS · NPI 1255380127
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanglewood Family Medical Center PA (8 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kansas Medical Center LLC Hospital · Andover, KS · CCN 170197

Medicare participation

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25736/brand/1/csg/1/fhir/r4

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 5, 2026.

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1609669308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 N ANDOVER RD",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670029527",
            "telephone_number": "316-247-5499",
            "fax_number": "316-351-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 N ANDOVER RD",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670029527",
            "telephone_number": "316-247-5499",
            "fax_number": "316-351-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "MICCA",
        "middle_name": "LYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-26",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-84308-062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mitzi M Bales, MD
• Lasheena Barnes, M.S.
• Sharon L Barocco, CRNA
• Melissa Bartlett, PTA
• Cheyenne Shelby Becker
• Caitlin Birlingmair, DNP, APRN, FNP-C
• Waneko Chantele Bivens, MM, PHD
• Stephanie Danielle Blake, DPT
• Jennifer Lynn Blickenstaff, LCP
• Sarah Blosser, APRN

All providers in Andover, KS · Family Nurse Practitioner in Kansas