William R. Gentry, Jr., PH.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P636 Issued in TN

Legal business name

WILLIAM R. GENTRY, JR., PH.D., P.C.

Practice address

1922 Exeter Rd
Suite 7
Germantown, TN 38138-2949

Phone

(901) 754-9688

Fax

(901) 754-8630

NPI assigned

Jun 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William R. Gentry Jr., PH.,D.

Title

Owner

Phone

(901) 754-9688

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judith G Carroll, PH.D.

  • Clinical Psychologist
  • Bartlett, TN
  • NPI 1548352677
  NPD (past)
• Rick W Eddleman, LCSW

  • Clinical Social Worker
  • Memphis, TN
  • NPI 1104998574
  NPD (past)
• Jerry Melcher, CLINICAL PSYCHOLOGIS

  • Clinical Psychologist
  • Jackson, TN
  • NPI 1013118934
  NPD (past)

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669675898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 EXETER RD",
            "address_2": "SUITE 7",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382949",
            "telephone_number": "901-754-9688",
            "fax_number": "901-754-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 EXETER RD",
            "address_2": "SUITE 7",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382949",
            "telephone_number": "901-754-9688",
            "fax_number": "901-754-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM R. GENTRY, JR., PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GENTRY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-754-9688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.,D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3684912",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3984947",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Beth Wiggins, LCSW
• Rance Ballard Wilbourn, MD
• Sara E Wiles, FNP
• Laura Lynn Wilkinson, OTR/L
• William H Light MD PC
• William Vance Shappley, Dba the Shappley Clin
• William W. Bucy, MD, PC
• Charles Blaine Williams, NP
• Dana Anne Williams, NP
• Erin Denise Healy Williams, OTR/L

• Clinical Psychologist in Germantown, TN
• Providers in Germantown, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.