NPIMap

Individual provider Active NPI

Mary Katherine Gentry, MD

  • Family Medicine Physician
  • Concord, NC
National Provider Identifier
1740488261
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008-01689 Issued in NC
Practice address
5641 Poplar Tent Rd
Ste 101
Concord, NC 28027-7533
Phone
(704) 782-1955
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2008-01689 NC
Family Medicine Physician 207Q00000X 2008-01689 NC Primary

Addresses

Primary practice location

5641 Poplar Tent Rd
Ste 101
Concord, NC 28027-7533

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025-2441
Phone (704) 786-6521

Other practice location 2

123 Professional Park Dr
Locust, NC 28097-7712
Phone (704) 403-6760

Other practice location 3

8560 Cook St
Mount Pleasant, NC 28124-7686
Phone (704) 436-6521

Other practice location 4

5727 Prosperity Crossing Dr
Ste 2200
Charlotte, NC 28269-2206
Phone (704) 863-9830

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mgentry128724@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928000213 NC Practitioner - Family Practice 7012033004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network Inc 2,324 clinicians

Practice addresses (Care Compare)

270 Copperfield Blvd NE
Suite 102
Concord, NC 28025-2443
Phone (704) 786-6521

270 Copperfield Neblvd
Suite 102
Concord, NC 28025-2443
Phone (704) 786-6521

5641 Poplar Tent Rd
Concord, NC 28027-7570

Hospital & facility affiliations

  • Atrium Health at Home University City Home health agency, Charlotte, NC, CCN 347254
  • Gentiva Health Services/Salisb Home health agency, Kannapolis, NC, CCN 347170
  • Adoration Home Health Home health agency, Concord, NC, CCN 347126
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
  • Atrium Health University City Hospital, Charlotte, NC, CCN 340166

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008-01689NCMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Oct 4, 2010 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 4, 2010 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

5727 Prosperity Crossing Dr
Ste 2200
Charlotte, NC 28269
Phone (704) 618-7894

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

5641 Poplar Tent Rd
Ste 101
Concord, NC 28027
Phone (704) 782-1955

123 Professional Park Dr
Locust, NC 28097
Phone (704) 403-6760

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

Interoperability endpoints

  • Direct secure messaging: mgentry128724@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1740488261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5641 POPLAR TENT RD",
            "address_2": "STE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280277533",
            "telephone_number": "704-782-1955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Copperfield Blvd NE",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252441",
            "country_code": "US",
            "telephone_number": "704-786-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Locust",
            "state": "NC",
            "postal_code": "280977712",
            "country_code": "US",
            "telephone_number": "704-403-6760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8560 Cook St",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "NC",
            "postal_code": "281247686",
            "country_code": "US",
            "telephone_number": "704-436-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5727 Prosperity Crossing Dr",
            "address_2": "Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282692206",
            "country_code": "US",
            "telephone_number": "704-863-9830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2008-01689",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2008-01689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgentry128724@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "5641 Poplar Tent Rd",
            "address_2": "Ste 101",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280277533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.