IndividualActive
Jacob Bentley, CO, LO
NPI 1417127432 · Orthotist · Hiram, GA
Provider details
- NPI number
- 1417127432
- Entity type
- Individual
- Primary specialty
- OrthotistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CO, LO
- Sex
- Male
- Sole proprietor
- No
- License
- 14 (GA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
127 Enterprise Path
Ste 403
Hiram, GA 30141-2697
Phone: (678) 384-1921
Fax: (678) 384-1922
Street-level locationGet directions
Mailing address
1619 John Orr Dr
Tifton, GA 31794-3640
Registry dates
- Enumerated
- 2008-03-05
- Last updated
- 2011-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.