Active NPI
Jan C Gentry, LCSW
- Clinical Social Worker
- Tulsa, OK
National Provider Identifier
1689686164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1470
- Practice address
- 9322 E 41St St
RM 257
Tulsa, OK 74145-3721 - Phone
- (918) 628-2708
- NPI assigned
- Aug 12, 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1470 | OK | Primary |
Addresses
Primary practice location
9322 E 41St St
RM 257
Tulsa, OK 74145-3721
Mailing address
9322 E 41St
RM 257
Tulsa, OK 74145-6106
Phone (918) 628-2708
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1470 | OK | MD | Exercise & Sports Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286409600000",
"number": "1689686164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9322 E 41ST",
"address_2": "RM 257",
"city": "TULSA",
"state": "OK",
"postal_code": "741456106",
"telephone_number": "918-628-2708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9322 E 41ST ST",
"address_2": "RM 257",
"city": "TULSA",
"state": "OK",
"postal_code": "741453721",
"telephone_number": "918-628-2708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTRY",
"first_name": "JAN",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2010-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "1470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.