Bentley, Shannon K
Bentley, Shannon K is an individual health care provider with primary practice located at 413 South Loop Road St Elizabeth Family Practice Center, Edgewood KY 41017-5446. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Bentley, Shannon K can be contacted via phone (859) 301-3800.Contact Information
Primary practice address
413 South Loop Road St Elizabeth Family Practice Center
Edgewood KY 41017-5446
Phone: (859) 301-3800
Fax: (859) 301-3987
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35.075269 | Ohio |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 22184 | West Virginia |
| Allopathic & Osteopathic Physicians / Obstetrics | 207VX0000X | 49699 | Kentucky |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 49699 | Kentucky |
Profile Details
| NPI number | 1033179817 |
|---|---|
| LBN Legal business name | Bentley, Shannon K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Aug 10th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033179817 | NPPES |
| Kentucky | MEDICAID | 7100457110 | |
| Kentucky | Other | K228150 |
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