Individual provider Active NPI

Logan Gentry, PT, DPT

  • Physical Therapist
  • Ada, OK
National Provider Identifier
1184438202
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6656 Issued in OK
Practice address
2020 Arlington St Ste 3
Ada, OK 74820-2822
Phone
(580) 332-5124
NPI assigned
Feb 7, 2025
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6656 OK Primary

Addresses

Primary practice location

2020 Arlington St Ste 3
Ada, OK 74820-2822

Mailing address

2301 Williams Dr
Sulphur, OK 73086-1444

Other practice location 1

824 NW 45th St
Oklahoma City, OK 73118-6434
Phone (580) 371-1343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250303001911 OK Practitioner - Physical Therapist in Private Practice 3779004056 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc CurrentSince Feb 10, 2025 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients
Stellar Physical Therapy and Wellness, LLC Physical Therapist CurrentSince Sep 14, 2025 Accepting new patients

Locations

2020 Arlington St
Ste 3
Ada, OK 74820
Phone (580) 332-5124

1233 E State Highway 152
Mustang, OK 73064
Phone (405) 674-0101

1010 Garth Brooks Blvd
Ste 135
Yukon, OK 73099
Phone (405) 350-2000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1738886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1184438202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 WILLIAMS DR",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730861444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 ARLINGTON ST STE 3",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202822",
            "telephone_number": "580-332-5124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "824 NW 45th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731186434",
            "country_code": "US",
            "telephone_number": "580-371-1343",
            "fax_number": "405-767-0273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "LOGAN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.