Active NPI
Joseph A Gentry, PH.D.
- Intellectual & Developmental Disabilities Psychologist
- Phoenix, AZ
National Provider Identifier
1457501876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- 3913
- Practice address
- 7600 N 16TH St Ste 110
Phoenix, AZ 85020-4446 - Phone
- (602) 368-3282
- NPI assigned
- Sep 22, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BA15 | AZ | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 3913 | AZ | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 3913 | AZ | Primary |
Addresses
Primary practice location
7600 N 16TH St Ste 110
Phoenix, AZ 85020-4446
Mailing address
7600 N 16TH St Ste 110
Phoenix, AZ 85020-4446
Phone (602) 368-3282
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
| License | State | Type | Specialty |
|---|---|---|---|
| BA15 | AZ | MD | Behavioral Analyst |
| 3913 | AZ | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583366400000",
"number": "1457501876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7600 N 16TH ST STE 110",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850204446",
"telephone_number": "602-368-3282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 N 16TH ST STE 110",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850204446",
"telephone_number": "602-368-3282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTRY",
"first_name": "JOSEPH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-22",
"last_updated": "2020-03-05",
"certification_date": "2020-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "BA15",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "AZ",
"license": "3913",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "AZ",
"license": "3913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.