Active NPI
Gentry Parker Damron, DO
- Family Medicine Physician
- Rogers, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- E-17789
- Practice address
- 4502 S Dixieland Rd
Rogers, AR 72758-3067 - Phone
- (479) 877-7800
- Fax
- (479) 877-7801
- NPI assigned
- Apr 1, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | E-17789 | AR | Primary |
Addresses
Primary practice location
4502 S Dixieland Rd
Rogers, AR 72758-3067
Mailing address
PO Box 776084
Chicago, IL 60677-6084
Phone (479) 877-7800
Other practice location 1
311 E Matthews Ave
Jonesboro, AR 72401-3125
Phone (870) 972-0063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4502 S Dixieland Rd
Rogers, AR 72758-2300
Phone (479) 877-7800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-17789 | AR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients |
Locations
3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100
4502 S Dixieland Rd
Rogers, AR 72758
Phone (479) 877-7800
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Rogers, AR
- NPI 1265490916
-
- Endocrinology, Diabetes & Metabolism Physician
- Rogers, AR
- NPI 1770087371
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rogers, AR
- NPI 1316902414
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1063152338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776084",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776084",
"telephone_number": "479-877-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 S DIXIELAND RD",
"city": "ROGERS",
"state": "AR",
"postal_code": "727583067",
"telephone_number": "479-877-7800",
"fax_number": "479-877-7801"
}
],
"practiceLocations": [
{
"address_1": "311 E Matthews Ave",
"address_purpose": "LOCATION",
"city": "Jonesboro",
"state": "AR",
"postal_code": "724013125",
"country_code": "US",
"telephone_number": "870-972-0063",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAMRON",
"first_name": "GENTRY",
"middle_name": "PARKER",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-01",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E-17789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.