Individual provider Active NPI

Charles Gentry, PA-C

  • Physician Assistant
  • Bartlett, TN
National Provider Identifier
1366309791
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3336 Nancy LN
Bartlett, TN 38134-2801
Phone
(281) 219-5239
NPI assigned
Jan 7, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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 TN Primary

Addresses

Primary practice location

3336 Nancy LN
Bartlett, TN 38134-2801

Mailing address

3336 Nancy LN
Bartlett, TN 38134-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20260624005110 TN Practitioner - Physician Assistant 3476026048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Tennessee, HSC, College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

850 Poplar Ave
BLDG 2
Memphis, TN 38105-4607

850 Poplar Ave BLDG
Suite 2
Memphis, TN 38105-4607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1366309791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 NANCY LN",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 NANCY LN",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342801",
            "telephone_number": "281-219-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

Verify at the official NPI Registry.