NPIMap

Individual provider Active NPI

Cory Gentner, APRN

  • Nurse Practitioner
  • Reno, NV
National Provider Identifier
1629800818
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
881084 Issued in NV
Practice address
5590 Kietzke LN
Reno, NV 89511-3019
Phone
(775) 323-2080
NPI assigned
Aug 15, 2024
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 881084 NV Primary

Addresses

Primary practice location

5590 Kietzke LN
Reno, NV 89511-3019

Mailing address

5590 Kietzke LN
Reno, NV 89511-3019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241028000827 NV Practitioner - Nurse Practitioner 6608309844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Custom Physical Therapy Limited PartnershipGroup PAC ID 1355252842, shared by 2 NPIs, 76 clinicians
Sierra Neurosurgery GroupGroup PAC ID 3870588619, 24 clinicians

Practice addresses (Care Compare)

440 E Golden Valley Rd
Suite Aandb
Reno, NV 89506-5722
Phone (775) 360-3000

5590 Kietzke LN
Reno, NV 89511-3019
Phone (775) 323-2080

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
881084NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Neurosurgery Group CurrentSince Sep 1, 2024 Accepting new patients
Sierra Neurosurgery Group CurrentSince Sep 1, 2024 Accepting new patients

Locations

5590 Kietzke Ln
Reno, NV 89511
Phone (775) 323-2080

Interoperability endpoints

  • Direct secure messaging: cory.gentner.1@13729.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/13729/brand/6/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1629800818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 KIETZKE LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5590 KIETZKE LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-323-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTNER",
        "first_name": "CORY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "881084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.