Individual provider Active NPI

David Whelchel Gentry, MSSW

  • Mental Health Counselor
  • Kings Mountain, NC
National Provider Identifier
1730127911
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C003234 Issued in NC
Practice address
533 Patterson Rd
Kings Mountain, NC 28086-8924
Phone
(704) 739-0365
Fax
(877) 416-0624
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C003234 NC Primary

Addresses

Primary practice location

533 Patterson Rd
Kings Mountain, NC 28086-8924

Mailing address

533 Patterson Rd
Kings Mountain, NC 28086-8924
Phone (704) 739-0365

Other identifiers 1

IdentifierTypeStateIssuer
6002011MedicaidNC

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

LicenseStateTypeSpecialty
C003234NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1730127911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 PATTERSON RD",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280868924",
            "telephone_number": "704-739-0365",
            "fax_number": "877-416-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 PATTERSON RD",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280868924",
            "telephone_number": "704-739-0365",
            "fax_number": "877-416-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "DAVID",
        "middle_name": "WHELCHEL",
        "name_prefix": "Mr.",
        "credential": "MSSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C003234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002011",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.