Matt Gentry

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

210 Oak St # 300
Poteau, OK 74953-2339

Phone

(918) 649-0067

Fax

(918) 647-5285

NPI assigned

May 29, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1063824647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 833",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749530833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 OAK ST # 300",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532339",
            "telephone_number": "918-649-0067",
            "fax_number": "918-647-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "MATT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Poteau, OK
• Providers in Poteau, OK by specialty
• Behavior Analyst in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.