Kimberly Ann Callaway Gentry, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

202217 Issued in AR

Practice address

317 Oak St Ste 3
Conway, AR 72032-5679

Phone

(501) 358-6396

NPI assigned

Jun 3, 2020

Last updated

Jan 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kim Gentry Professional name

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapy Assessment Center, LLC

  • Group Psychotherapy Psychologist
  • Conway, AR
  • NPI 1093184210
  Medicare reassignment NPD
• Therapy Assessment Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Conway, AR
  • NPI 1487492153
  NPD
• Arkansas Families First LLC

  • Family Psychologist
  • North Little Rock, AR
  • NPI 1659618304
  NPD (past)
• Pediatrics Plus Counseling & Diagnostics LLC

  dba Rise Counseling and Diagnostics

  • Adolescent and Children Mental Health Clinic/Center
  • Little Rock, AR
  • NPI 1194217703
  NPD (past)

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1073137253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 COLT LOOP",
            "city": "GREENBRIER",
            "state": "AR",
            "postal_code": "720589197",
            "telephone_number": "501-581-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 OAK ST STE 3",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325679",
            "telephone_number": "501-358-6396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Business Park Dr Ste 5",
            "address_purpose": "LOCATION",
            "city": "Greenbrier",
            "state": "AR",
            "postal_code": "720589286",
            "country_code": "US",
            "telephone_number": "501-581-7703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAWAY GENTRY",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "202217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "GENTRY",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Libby Nicole Caldwell-Willis
• Diana Caldwell, MS CCC-SLP
• Kimberley Nicole Calhoon
• Phakeshia Calico, RECOVERY ASSISTANT
• Douglas G Callahan, MD
• Shelbi Lynn Calloway
• Kylie Calvin
• Camden Medical Supply Inc (Rotech)
• Angela Campagna, LCSW
• Amanda Campbell, CASE MANAGER PARAPRO

• Psychologist in Conway, AR
• Providers in Conway, AR by specialty
• Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.