Individual provider Active NPI

Lynwood Overton Gentry Jr., PHD OTR/L

  • Contractor
  • Richmond, VA
National Provider Identifier
1396997722
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
0119001845 Issued in VA
Practice address
8520 Sunview LN
Richmond, VA 23235-4150
Phone
(804) 267-1947
NPI assigned
Oct 16, 2008
Last updated
Oct 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 0119001845 VA Primary

Addresses

Primary practice location

8520 Sunview LN
Richmond, VA 23235-4150

Mailing address

8520 Sunview LN
Richmond, VA 23235-4150
Phone (804) 267-1947

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0119001845VAMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1396997722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8520 SUNVIEW LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354150",
            "telephone_number": "804-267-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8520 SUNVIEW LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354150",
            "telephone_number": "804-267-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "LYNWOOD",
        "middle_name": "OVERTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "VA",
            "license": "0119001845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.