Michael Allen Gentry, M.D.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

29675 Issued in MO

Practice address

1722 S Glenstone Ave
Suite K
Springfield, MO 65804-1519

Phone

(417) 883-8162

Fax

(417) 883-6225

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1477577633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 S GLENSTONE AVE",
            "address_2": "SUITE K",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041519",
            "telephone_number": "417-883-8162",
            "fax_number": "417-883-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 S GLENSTONE AVE",
            "address_2": "SUITE K",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041519",
            "telephone_number": "417-883-8162",
            "fax_number": "417-883-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MO",
            "license": "29675",
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Joy Gelber, RD
• Dakota Gelsheimer
• Carlye Genisio, LMSW
• Janine Gentile, MA, LPC
• Gentle Touch Home Care LLC
• Sheryl L Gentry
• Erin Genua, O.D.
• Brittany Nicole George
• Reggie L George, MD
• Sheila George, CDE

• Procedural Dermatology Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Procedural Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.