Active NPI
Donald Max Gentry, MD
- Family Medicine Physician
- Scottsbluff, NE
National Provider Identifier
1275529596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11835
- Practice address
- 3911 Avenue B
Suite 2110
Scottsbluff, NE 69361-4617 - Phone
- (308) 630-2100
- Fax
- (308) 630-2113
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11835 | NE | Primary |
Addresses
Primary practice location
3911 Avenue B
Suite 2110
Scottsbluff, NE 69361-4617
Mailing address
3911 Avenue B
Suite 2110
Scottsbluff, NE 69361-4617
Phone (308) 630-2100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11835 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196899200000",
"number": "1275529596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3911 AVENUE B",
"address_2": "SUITE 2110",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614617",
"telephone_number": "308-630-2100",
"fax_number": "308-630-2113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3911 AVENUE B",
"address_2": "SUITE 2110",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614617",
"telephone_number": "308-630-2100",
"fax_number": "308-630-2113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTRY",
"first_name": "DONALD",
"middle_name": "MAX",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2007-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "11835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsbluff, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.