EMMETT M BENTLEY, D.O. — NPI 1487725966 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Pathology, Anatomic Pathology & Clinical Pathology in SAINT LOUIS, MO)

CMS-1500 Box 24J / 33a • NPI

1487725966

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207ZP0102X (CMS 22)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Pathology, Anatomic Pathology & Clinical Pathology

Box 32 Service Location & ZIP+4

2345 DOUGHERTY FERRY RD, SAINT LOUIS, MO, 63122-3313

✓ 9-Digit EDI 837 ZIP+4 (63122-3313)

Practice Phone & Referral Fax

(314) 966-9590

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1487725966 (EMMETT M BENTLEY, D.O.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1487725966` (NPI-1 Individual Practitioner)
Provider / Legal Name	EMMETT M BENTLEY, D.O.
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Pathology, Anatomic Pathology & Clinical Pathology NUCC Code: `207ZP0102X` (Pathology, Anatomic Pathology & Clinical Pathology)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2345 DOUGHERTY FERRY RD, SAINT LOUIS, MO, 63122-3313
Practice Telephone / Fax	Tel: (314) 966-9590
Administrative Mailing Address	800 SAINT PAUL RD, WILDWOOD, MO, 63021-6011
Enumeration & Last Sync	Enumerated: 2006-11-13 \| CMS Record Updated: 2007-07-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2345 DOUGHERTY FERRY RD, SAINT LOUIS, MO, 63122-3313

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Plain-English Taxonomy & CMS Crosswalk (207ZP0102X)

What Does Taxonomy Code 207ZP0102X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207ZP0102X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Pathology, Anatomic Pathology & Clinical Pathology"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 22 (Physician/Pathology)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pathology, Anatomic Pathology & Clinical Pathology for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (EMMETT M BENTLEY, D.O.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207ZP0102X` — Pathology, Anatomic Pathology & Clinical Pathology Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pathology, Anatomic Pathology & Clinical Pathology	State: MO \| License: `DOR9613` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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EMMETT M BENTLEY, D.O. (NPI #1487725966)