Individual provider Active NPI

Erika D Gentry, MD

  • Family Medicine Physician
  • Sugar Land, TX
National Provider Identifier
1639259989
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K2698 Issued in TX
Practice address
17510 W Grand Pkwy S
Suite 380
Sugar Land, TX 77479-2645
Phone
(281) 238-0200
Fax
(281) 232-5792
NPI assigned
Oct 17, 2006
Last updated
Mar 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K2698 TX Primary

Addresses

Primary practice location

17510 W Grand Pkwy S
Suite 380
Sugar Land, TX 77479-2645

Mailing address

17510 W Grand Pkwy S
Suite 380
Sugar Land, TX 77479-2645
Phone (281) 238-0200

Other identifiers 2

IdentifierTypeStateIssuer
144051302MedicaidTX
8078M6MedicaidTX

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

LicenseStateTypeSpecialty
K2698TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Family Medicine and Wellness Center, PA Family Medicine PastSince Jun 1, 2008 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1639259989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17510 W GRAND PKWY S",
            "address_2": "SUITE 380",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792645",
            "telephone_number": "281-238-0200",
            "fax_number": "281-232-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17510 W GRAND PKWY S",
            "address_2": "SUITE 380",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792645",
            "telephone_number": "281-238-0200",
            "fax_number": "281-232-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "ERIKA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K2698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144051302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8078M6",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.