Individual provider Active NPI

Adrienne L Gentry

  • Obstetrics & Gynecology Physician
  • Roanoke, VA
National Provider Identifier
1437458650
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0102205233 Issued in VA
Practice address
1231 S Jefferson St
Roanoke, VA 24016-4705
Phone
(540) 985-8078
Fax
(540) 985-8085
NPI assigned
Mar 28, 2011
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0102205233 VA Primary

Addresses

Primary practice location

1231 S Jefferson St
Roanoke, VA 24016-4705

Mailing address

1231 S Jefferson St
Roanoke, VA 24016-4705
Phone (540) 985-8078

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agentry4524@direct.carilionclinic.org Direct

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
I20150522000244 KY Practitioner - Obstetrics/Gynecology 2668615469 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP296KYMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Obstetrics & Gynecology CurrentSince Jul 13, 2015 Accepting new patients
University of Louisville Physicians, Inc. Obstetrics & Gynecology Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 13, 2015 Accepting new patients
North Florida Reproductive Medicine, LLC Past Accepting new patients
Reproductive Medicine Associates, P.a. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

401 E Chestnut St
Unit 410
Louisville, KY 40202
Phone (502) 271-5999

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Interoperability endpoints

  • Direct secure messaging: agentry4524@direct.carilionclinic.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1437458650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164705",
            "telephone_number": "540-985-8078",
            "fax_number": "540-985-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164705",
            "telephone_number": "540-985-8078",
            "fax_number": "540-985-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "ADRIENNE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0102205233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agentry4524@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "agentry4524@direct.carilionclinic.org",
            "address_1": "1231 S Jefferson St",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240164705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.