Individual provider Active NPI

Eileen Pauline Gentry, FNP-C

  • Nurse Practitioner
  • Tarboro, NC
National Provider Identifier
1417668807
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5017321 Issued in NC
Practice address
105 Hospital Dr
Tarboro, NC 27886-2011
Phone
(252) 641-7714
NPI assigned
Dec 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5017321 NC Primary

Addresses

Primary practice location

105 Hospital Dr
Tarboro, NC 27886-2011

Mailing address

736 Henry St
Roanoke Rapids, NC 27870-2611
Phone (919) 538-8171

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
I20230213001390 NC Practitioner - Nurse Practitioner 8022480425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

1001 W Williams St
Suite 103
Apex, NC 27502-3978
Phone (919) 439-7867

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5017321NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jan 31, 2023 Accepting new patients
East Carolina Anesthesia Associates, PLLC CurrentSince Jan 15, 2025 Accepting new patients

Locations

1001 W Williams St
Ste 103
Apex, NC 27502
Phone (919) 363-2111

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2080 W Arlington Blvd
Ste B
Greenville, NC 27834
Phone (252) 752-2140

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

257 NC Highway 125
Roanoke Rapids, NC 27870
Phone (252) 410-0001

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

105 Hospital Dr
Tarboro, NC 27886
Phone (252) 641-7714

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1417668807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 HENRY ST",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278702611",
            "telephone_number": "919-538-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HOSPITAL DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862011",
            "telephone_number": "252-641-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "EILEEN",
        "middle_name": "PAULINE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarboro, NC

Sources for this page

Verify at the official NPI Registry.