Active NPI
Warren Douglas Gentry, M.D.
- Family Medicine Physician
- Clemson, SC
National Provider Identifier
1598825739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9992
- Practice address
- 522 College Ave
Suite 1
Clemson, SC 29631-1443 - Phone
- (864) 654-7841
- Fax
- (864) 654-7641
- NPI assigned
- Dec 11, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9992 | SC | Primary |
Addresses
Primary practice location
522 College Ave
Suite 1
Clemson, SC 29631-1443
Mailing address
522 College Ave
Suite 1
Clemson, SC 29631-1443
Phone (864) 654-7841
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| # 9992 | Other | SC | STATE LICENSE NUMBER |
| 099921 | Medicaid | SC | |
| D907172212 | Other | SC | INDIVIDUAL MEDICARE NUMBE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Medical University of South Carolina College of Medicine, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
522 College Ave
Suite 1
Clemson, SC 29631-1443
Phone (864) 654-7841
Hospital & facility affiliations
- Centerwell Home Health
- Interim Healthcare of the Upstate
- Prisma Health Oconee Memorial Hospital
- Anmed Health
- Prisma Health Greenville Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9992 | SC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| F.M.a., P.a. | Family Medicine | Current | Accepting new patients |
Locations
522 College Ave
#1
Clemson, SC 29631
Phone (803) 654-7841
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Clemson, SC
- NPI 1053426353
Hospital & facility affiliations 45
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Anderson, SC
- NPI 1417919531
-
- Home Health Agency
- Greenville, SC
- NPI 1598793192
-
- Home Health Agency
- Greenville, SC
- NPI 1750897609
-
- General Acute Care Hospital
- Seneca, SC
- NPI 1063968196
-
- Medically Fragile Infants and Children Day Care
- Greenville, SC
- NPI 1093168064
Hospital
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1114473212
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1174079271
-
- Sleep Disorder Diagnostic Clinic/Center
- Greenville, SC
- NPI 1275086431
Hospital
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1326884982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344384000000",
"number": "1598825739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 COLLEGE AVE",
"address_2": "SUITE 1",
"city": "CLEMSON",
"state": "SC",
"postal_code": "296311443",
"telephone_number": "864-654-7841",
"fax_number": "864-654-7641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 COLLEGE AVE",
"address_2": "SUITE 1",
"city": "CLEMSON",
"state": "SC",
"postal_code": "296311443",
"telephone_number": "864-654-7841",
"fax_number": "864-654-7641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTRY",
"first_name": "WARREN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2012-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "9992",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "# 9992",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "099921",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL MEDICARE NUMBE",
"identifier": "D907172212",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clemson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.