Individual provider Active NPI

Rosalyn Dunlap Gentry, EXECUTIVE DIRECTOR

  • Case Manager/Care Coordinator
  • Altamonte Springs, FL
National Provider Identifier
1285987925
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
901 Douglas Ave Ste 205
Altamonte Springs, FL 32714-2057
Phone
(407) 703-5959
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

901 Douglas Ave Ste 205
Altamonte Springs, FL 32714-2057

Mailing address

6123 Metrowest Blvd Unit 116
Orlando, FL 32835-2963
Phone (407) 703-5959

Other identifiers 1

IdentifierTypeStateIssuer
003564600MedicaidFL

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Destiny TCM Corporation Past Accepting new patients

Organizations & group practices 1

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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1285987925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6123 METROWEST BLVD UNIT 116",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328352963",
            "telephone_number": "407-703-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DOUGLAS AVE STE 205",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142057",
            "telephone_number": "407-703-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNLAP GENTRY",
        "first_name": "ROSALYN",
        "credential": "EXECUTIVE DIRECTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003564600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.