Active NPI
Kevin Gentry
- Technician
- Macon, GA
National Provider Identifier
1699461350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- Practice address
- 3640 Eisenhower Pkwy
Macon, GA 31206-3676 - Phone
- (770) 946-2453
- Fax
- (478) 294-1866
- NPI assigned
- Apr 14, 2023
- 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 |
|---|---|---|---|---|
| Technician | 374700000X | GA | Primary |
Addresses
Primary practice location
3640 Eisenhower Pkwy
Macon, GA 31206-3676
Mailing address
5869 US Highway 80 E
Knoxville, GA 31050-2562
Phone (770) 946-2453
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681430400000",
"number": "1699461350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5869 US HIGHWAY 80 E",
"city": "KNOXVILLE",
"state": "GA",
"postal_code": "310502562",
"telephone_number": "770-946-2453",
"fax_number": "478-294-1866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3640 EISENHOWER PKWY",
"city": "MACON",
"state": "GA",
"postal_code": "312063676",
"telephone_number": "770-946-2453",
"fax_number": "478-294-1866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTRY",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-14",
"last_updated": "2023-04-14",
"certification_date": "2023-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
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- Georgia Arrhythmia Consultants and Research Institute
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.