Gentry Nurse Practitioner in Family Health

Organization Active NPI Family Nurse Practitioner · King Ferry, NY

NPI 1225825110 · NPPES record last updated Apr 5, 2026

Key facts

NPI
1225825110
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
Legal business name
GENTRY NURSE PRACTITIONER IN FAMILY HEALTH
Practice address
968 Deer Trail Rd S
King Ferry, NY 13081-8712
Phone
(315) 767-3717
NPI assigned
Apr 23, 2025
Organization subpart
No

Authorized official

Name
Donnie Gentry Jr. NPI 1497107619
Title
Owner
Phone
(315) 767-3717

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250603001049 NY Part B Supplier - Clinic/Group Practice 4082123914 Receives reassigned benefits from 1 practitioner
Practice locations: King Ferry, NY

National Provider Directory

Locations

53 Lexington Ave
Ste 400
New York, NY 10010
Phone (607) 299-5929

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X Yes

Addresses

Primary practice location

968 Deer Trail Rd S
King Ferry, NY 13081-8712

Mailing address

968 Deer Trail Rd S
King Ferry, NY 13081-8712

Other practice location 1

53 Lexington Ave Ste 400
New York, NY 10010-5585
Phone (607) 299-5929

Other providers in King Ferry, NY

All providers in King Ferry, NY · Family Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.