Teresa Jean Bentley, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

22399 Issued in KY

Practice address

120 Tradepark Dr
Suite B
Somerset, KY 42503-3454

Phone

(606) 679-9292

Fax

(606) 679-9294

NPI assigned

Jan 18, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Dermatology Center of Lake Cumberland, PSC

  • Dermatology Physician
  • Somerset, KY
  • NPI 1477639243
  Authorized official Same address or phone

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922150994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 WOODHAVEN DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425039528",
            "telephone_number": "606-679-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 TRADEPARK DR",
            "address_2": "SUITE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033454",
            "telephone_number": "606-679-9292",
            "fax_number": "606-679-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "TERESA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "22399",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": "22399",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "KY",
            "license": "22399",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "KY",
            "license": "22399",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000048629",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64223993",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070007354",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Benge Reynolds
• Karen Bennett-Baker, ARNP
• Andrea Bennett
• Duncan Bennett
• Nathan Kyle Bennett, PA-C
• Bernard Williams
• Ashley Conover Bernard, MS, SLP-CCC
• Amber Nichole Beshear-Tarter, APRN
• Melinda Bess, APRN-FNP BC
• Issis M. Betts-Jimenez, MA

• Dermatology Physician in Somerset, KY
• Providers in Somerset, KY by specialty
• Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.