Individual provider Active NPI

Gentry C Larue Jr., M.D.

  • Psychiatry Physician
  • Lexington, KY
National Provider Identifier
1316974314
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25320 Issued in KY
Practice address
496 Southland Dr
Lexington, KY 40503-1827
Phone
(859) 288-2425
Fax
(859) 721-2572
NPI assigned
Jun 26, 2006
Last updated
Jan 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 385 KY
Psychiatry Physician 2084P0800X 25320 KY Primary

Addresses

Primary practice location

496 Southland Dr
Lexington, KY 40503-1827

Mailing address

496 Southland Dr
Lexington, KY 40503-1827
Phone (859) 288-2392

Other identifiers 1

IdentifierTypeStateIssuer
7100164390MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20120214000461 KY Practitioner - Psychiatry 4082871470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Kentucky College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthfirst Bluegrass IncGroup PAC ID 5890961593, 26 clinicians

Practice addresses (Care Compare)

496 Southland Dr
Lexington, KY 40503-1827
Phone (859) 288-2425

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
385KYMDForensic Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthfirst Bluegrass Inc CurrentSince May 20, 2019 Accepting new patients
Healthfirst Bluegrass Inc. CurrentSince May 20, 2019 Accepting new patients
Healthfirst Bluegrass Inc PastSince Oct 1, 2019 Accepting new patients

Locations

1060 Goodwin Dr
#110
Lexington, KY 40505

1640 Bryan Station Rd
#1
Lexington, KY 40505

1640 Bryan Station Rd
Ste 1
Lexington, KY 40505

360 W Loudon Ave
Lexington, KY 40508
Phone (859) 252-7881

496 Southland Dr
Lexington, KY 40503
Phone (859) 288-2392

576 E Third St
Ste 170
Lexington, KY 40508
Phone (859) 402-8945

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1316974314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2392",
            "fax_number": "859-721-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2425",
            "fax_number": "859-721-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUE",
        "first_name": "GENTRY",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "KY",
            "license": "385",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "25320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100164390",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.