Individual provider Active NPI

Kelsey Gentry, PA

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1356799126
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002047A Issued in IN
Practice address
7930 N Shadeland Ave
Indianapolis, IN 46250-2942
Phone
(317) 621-6725
Fax
(317) 621-4545
NPI assigned
Jun 2, 2016
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002047A IN Primary

Addresses

Primary practice location

7930 N Shadeland Ave
Indianapolis, IN 46250-2942

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-1647

Other practice location 1

1542 S Bloomington St
Greencastle, IN 46135-2212
Phone (765) 658-2700

Other identifiers 1

IdentifierTypeStateIssuer
300025586MedicaidIN

Other names 1

  • Kelsey Futter Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kfutter186309@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160713000191 IN Practitioner - Physician Assistant 2961794888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1500 N Ritter Ave
Indianapolis, IN 46219-3027

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 621-6262

7930 N Shadeland Ave
Suite 100
Indianapolis, IN 46250-2943
Phone (317) 621-6725

9669 E 146TH St
Noblesville, IN 46060-5006

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Putnam County Hospital CurrentSince May 1, 2016 Accepting new patients
Putnam County Hospital CurrentSince May 1, 2016 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jun 17, 2019 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jun 17, 2019 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

51 E Market St
Cloverdale, IN 46120
Phone (765) 795-4242

1542 S Bloomington St
Greencastle, IN 46135
Phone (765) 522-2556

1542 S Bloomington St
#1100
Greencastle, IN 46135
Phone (765) 658-2700

1542 S Bloomington St
Ste 1100
Greencastle, IN 46135
Phone (765) 658-2700

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7930 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-6725

Interoperability endpoints

  • Direct secure messaging: kfutter186309@ecommunitydirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1356799126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7930 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502942",
            "telephone_number": "317-621-6725",
            "fax_number": "317-621-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1542 S Bloomington St",
            "address_purpose": "LOCATION",
            "city": "Greencastle",
            "state": "IN",
            "postal_code": "461352212",
            "country_code": "US",
            "telephone_number": "765-658-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "KELSEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002047A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300025586",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfutter186309@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7930 N Shadeland Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "FUTTER",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.