Individual provider Active NPI

Barry Chance Gentry, M.D.

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1194796136
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101263905 Issued in VA
Practice address
5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone
(757) 473-3969
NPI assigned
Jan 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101263905 VA Primary

Addresses

Primary practice location

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (757) 393-1136

Other practice location 1

825 Fairfax Ave Ste 118
Norfolk, VA 23507-1912
Phone (757) 446-5955

Other practice location 2

549 E Brambleton Ave
Norfolk, VA 23510-2905
Phone (757) 393-1136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180906001871 VA Practitioner - Family Practice 5890926687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101263905VAMDFamily Medicine Physician
33989TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jencare Neighborhood Medical Norfolk, LLC CurrentSince Apr 1, 2021 Accepting new patients
PMR Virginia Holding, LLC CurrentSince Jul 1, 2021 Accepting new patients
Jencare Neighborhood Medical Center Virginia Beach LLC CurrentSince May 25, 2021 Accepting new patients
Coastal Podiatry, Inc PastSince Aug 6, 2018 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

549 E Brambleton Ave
Norfolk, VA 23510
Phone (757) 393-1136

5516 Virginia Beach Blvd
Virginia Beach, VA 23462
Phone (757) 287-3699

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1194796136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "757-393-1136",
            "fax_number": "757-446-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625629",
            "telephone_number": "757-473-3969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Fairfax Ave Ste 118",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071912",
            "country_code": "US",
            "telephone_number": "757-446-5955",
            "fax_number": "757-446-5196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "549 E Brambleton Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235102905",
            "country_code": "US",
            "telephone_number": "757-393-1136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "BARRY",
        "middle_name": "CHANCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-29",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101263905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.