Individual provider Active NPI

David Wayne Gentry, M.D.

  • Nuclear Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1225180367
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
A95055 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4000
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X MD0000040690 TN
Nuclear Medicine Physician 207U00000X A95055 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

6321 Cate Rd
Powell, TN 37849-4952
Phone (865) 406-3698

Other practice location 1

1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone (865) 544-9070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070703000315 CA Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 9335249481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nuclear Medicine
Education
University of Tennessee, HSC, College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

25455 Barton Rd
Loma Linda, CA 92354-3128
Phone (909) 558-2808

28062 Baxter Rd
Murrieta, CA 92563-1401
Phone (909) 558-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95055CAMDNuclear Medicine Physician
MD0000040690TNMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 14, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 14, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Hospital Service District of the Parish of St. Bernard, State of Louis Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Pinnacle Medical Group, Inc. Past Accepting new patients

Locations

900 E Washington St
Ste 150
Colton, CA 92324
Phone (909) 433-0575

11234 Anderson St
Ste 1405
Loma Linda, CA 92350
Phone (909) 558-4252

25455 Barton Rd
Loma Linda, CA 92354
Phone (909) 558-2808

11370 Anderson St
Ste 1700
Loma Linda, CA 92354
Phone (909) 558-3016

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 107B
Loma Linda, CA 92354
Phone (909) 558-3016

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1225180367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6321 CATE RD",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378494952",
            "telephone_number": "865-406-3698",
            "fax_number": "865-938-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Alcoa Hwy",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "865-544-9070",
            "fax_number": "865-544-9074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "TN",
            "license": "MD0000040690",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "CA",
            "license": "A95055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.