Individual provider Active NPI

Susanna Gentry, FNP

  • Family Nurse Practitioner
  • Durham, NC
National Provider Identifier
1306463898
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5013263 Issued in NC
Practice address
2511 Old Cornwallis Rd
Durham, NC 27713-1869
Phone
(919) 932-5700
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5013263 NC
Family Nurse Practitioner 363LF0000X 2019045619 NC
Family Nurse Practitioner 363LF0000X 5013263 NC Primary

Addresses

Primary practice location

2511 Old Cornwallis Rd
Durham, NC 27713-1869

Mailing address

3422 Avent Ferry Rd
Raleigh, NC 27606-3646
Phone (410) 279-5050

Other practice location 1

250 Hospice Cir
Raleigh, NC 27607-6372
Phone (919) 828-0890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200827001916 NC Practitioner - Nurse Practitioner 9830516434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hospice of Wake County, IncGroup PAC ID 5294760427, 21 clinicians

Practice addresses (Care Compare)

250 Hospice Cir
Raleigh, NC 27607-6372
Phone (919) 828-0890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2019045619NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner CurrentSince Oct 5, 2021 Accepting new patients
Hospice of Wake County, Inc. Current Accepting new patients
Hospice of Wake County, Inc. Nurse Practitioner CurrentSince Mar 10, 2025 Accepting new patients

Locations

250 Hospice Cir
Raleigh, NC 27607
Phone (919) 828-0890

L2540
Columbus, OH 43260

Organizations & group practices 3

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": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1306463898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3422 AVENT FERRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063646",
            "telephone_number": "410-279-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 OLD CORNWALLIS RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277131869",
            "telephone_number": "919-932-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Hospice Cir",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076372",
            "country_code": "US",
            "telephone_number": "919-828-0890",
            "fax_number": "919-719-0395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "SUSANNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013263",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "2019045619",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5013263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.