Jennifer Bentley Kidd, M.D.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

J5542 Issued in TX

Practice address

401 S 12TH St
Port Aransas, TX 78373-5328

Phone

(210) 872-1863

NPI assigned

Apr 1, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Ryan Bentley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• City of San Antonio Texas

  • Public Health or Welfare Agency
  • San Antonio, TX
  • NPI 1639808363
  NPD (past)

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1659660348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "city": "PORT ARANSAS",
            "state": "TX",
            "postal_code": "783730328",
            "telephone_number": "210-872-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S 12TH ST",
            "city": "PORT ARANSAS",
            "state": "TX",
            "postal_code": "783735328",
            "telephone_number": "210-872-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "JENNIFER",
        "middle_name": "BENTLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "J5542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BENTLEY",
            "middle_name": "RYAN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Christine Flood, RN
• David Grodsky, MD
• Iuliana Baird Hofhiens, LMFT-A
• Island Durable Medical Equipment, LLC
• Island Home Health Care, Inc.
• Little Behavior Consulting on the Coast, LLC
• Elena Minnick
• Katherine Elizabeth Moore, FNP-BC, MSN, RN, BSN
• Robert Dale Mueller
• Port Aransas Pharmacy, L.C.

• Public Health & General Preventive Medicine Physician in Port Aransas, TX
• Providers in Port Aransas, TX by specialty
• Public Health & General Preventive Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.