Individual provider Active NPI

Jaryn S Gentry, FNP-C

  • Family Nurse Practitioner
  • Liberty, MO
National Provider Identifier
1699392415
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209021441 Issued in IL
Practice address
1860 N Church Rd
Liberty, MO 64068-7195
Phone
(816) 415-2828
NPI assigned
Jun 27, 2020
Last updated
Jun 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209021441 IL Primary
Family Nurse Practitioner 363LF0000X 2020003108 MO

Addresses

Primary practice location

1860 N Church Rd
Liberty, MO 64068-7195

Mailing address

1860 N Church Rd
Liberty, MO 64068-7195
Phone (816) 415-2828

Other names 1

  • Jaryn S Black Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200903003024 IL Practitioner - Nurse Practitioner 9537586532
I20220808001045 MO Practitioner - Nurse Practitioner 9537586532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergent Care Plus LLCGroup PAC ID 0547328460, 18 clinicians

Practice addresses (Care Compare)

10015 N Ambassador Dr
Suite 100
Kansas City, MO 64153-1437
Phone (816) 595-4000

1860 N Church Rd
Liberty, MO 64068-7179
Phone (816) 415-2828

2741 NE McBaine Dr
Lees Summit, MO 64064-7880
Phone (816) 554-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
2020003108MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Jun 27, 2022 Accepting new patients
Blessing Hospital CurrentSince Aug 15, 2020 Accepting new patients
Hannibal Regional Healthcare System, Inc Current Accepting new patients
Providence Urgent Care LLC CurrentSince Jul 29, 2009 Accepting new patients
Nextcare Missouri LLC CurrentSince Jun 1, 2025 Accepting new patients
Blessing Hospital Current Accepting new patients
Emergent Care Plus, LLC CurrentSince Jun 1, 2025 Accepting new patients
Hannibal Regional Healthcare System, Inc CurrentSince Jun 27, 2022 Accepting new patients
Blessing Hospital CurrentSince Aug 15, 2020 Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

1005 Broadway St
Quincy, IL 62301

624 W Lockling St
Brookfield, MO 64628
Phone (660) 258-3363

202 E Nifong Blvd
Columbia, MO 65203
Phone (573) 874-6824

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

1611 S Baltimore St
#A
Kirksville, MO 63501

2741 NE McBaine Dr
Lees Summit, MO 64064
Phone (816) 554-2600

1860 N Church Rd
Liberty, MO 64068
Phone (816) 368-8226

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: jaryn.black.p1@direct.cfmkv.nextgenshare.com

Organizations & group practices 9

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": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1699392415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 N CHURCH RD",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640687195",
            "telephone_number": "816-415-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 N CHURCH RD",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640687195",
            "telephone_number": "816-415-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "JARYN",
        "middle_name": "S",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-27",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021441",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020003108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JARYN",
            "last_name": "BLACK",
            "middle_name": "S",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.