F.M.a., P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9992 Issued in SC

Legal business name

F.M.A., P.A.

Doing business as

Family Medicine Associates

Practice address

522 College Ave
Suite 1
Clemson, SC 29631-1443

Phone

(864) 654-7841

Fax

(864) 654-7641

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Warren Douglas Gentry, M.D.NPI 1598825739

Title

President

Phone

(864) 654-7841

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Family Medicine Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Warren Douglas Gentry, M.D.

  • Family Medicine Physician
  • Clemson, SC
  • NPI 1598825739
  Medicare reassignment NPD Authorized official
• Katrina Sharpe Maxwell, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Anderson, SC
  • NPI 1851724272
  Medicare reassignment NPD

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1053426353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 COLLEGE AVE",
            "address_2": "SUITE 1",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311443",
            "telephone_number": "864-654-7841",
            "fax_number": "864-654-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 COLLEGE AVE",
            "address_2": "SUITE 1",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311443",
            "telephone_number": "864-654-7841",
            "fax_number": "864-654-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F.M.A., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "GENTRY",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-654-7841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "9992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. TOLBERT STATE LICENSE",
            "identifier": "24081",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENTRY STATE LICENSE",
            "identifier": "9992",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC3475",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ruth Anne Etter, FNP-BC
• Amanda Martin Eubanks, M.S. CCC-SLP
• John Glenn Evans, PHARMACIST
• Excel Rehabilitation and Sports (Excel Rehabilitation and Sports Enhancement)
• Excel Rehabilitation and Sports (Excel Rehabilitation and Sports Enhancement LLC)
• Family Vision of Anderson
• James E Feiste, MD
• Kenneth Ontario Felder, PT, DPT
• Timothy Edward Fenlon, MD
• Suzanne S Figliola, MS, RD, LD

• Family Medicine Physician in Clemson, SC
• Providers in Clemson, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.