Active NPI
W. Gentry, MD
- Anesthesiology Physician
- Little Rock, AR
National Provider Identifier
1487744959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- C-7480
- Practice address
- 4301 W Markham St # 783
Little Rock, AR 72205-7101 - Phone
- (501) 686-8000
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | C-7480 | AR | Primary |
Addresses
Primary practice location
4301 W Markham St # 783
Little Rock, AR 72205-7101
Mailing address
4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C7480 | Other | AR | CHAMPUS |
| 11774000000 | Other | AR | QUALCHOICE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-7480 | AR | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198627200000",
"number": "1487744959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 W MARKHAM ST # 783",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722057101",
"telephone_number": "501-686-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 W MARKHAM ST # 783",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722057101",
"telephone_number": "501-686-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTRY",
"first_name": "W.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AR",
"license": "C-7480",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "C7480",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "11774000000",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.