Individual provider Active NPI

William Allen Gentry, M.P.T.

  • Physical Therapist
  • Canton, GA
National Provider Identifier
1780602565
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008896 Issued in GA
Practice address
720 Transit Ave Ste 202
Canton, GA 30114-2544
Phone
(770) 721-8160
Fax
(770) 721-8173
NPI assigned
Jul 18, 2006
Last updated
Dec 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008896 GA Primary

Addresses

Primary practice location

720 Transit Ave Ste 202
Canton, GA 30114-2544

Mailing address

720 Transit Ave Ste 202
Canton, GA 30114-2544
Phone (770) 721-8160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080112000180 GA Practitioner - Physical Therapist in Private Practice 9638114036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Greystone Power Blvd
Dallas, GA 30157-0908
Phone (678) 453-5717

1121 Johnson Ferry Rd
Suite 200
Marietta, GA 30068-5425
Phone (770) 579-8558

1505 Stone Bridge Pkwy
Suite 200
Woodstock, GA 30189-8255

300 Tower Rd
Suite 200
Marietta, GA 30060-9403

300 Tower Rd NE
Suite 200
Marietta, GA 30060-9403
Phone (770) 427-5717

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC CurrentSince Nov 16, 2015 Accepting new patients

Locations

1121 Johnson Ferry Rd
Ste 200
Marietta, GA 30068
Phone (770) 579-8558

300 Tower Rd NE
Ste 101
Marietta, GA 30060
Phone (770) 218-0219

300 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 427-5717

3747 Roswell Rd
Ste 319
Marietta, GA 30062
Phone (770) 579-8558

Interoperability endpoints

  • Direct secure messaging: william.gentry.1@15749.direct.athenahealth.com

Organizations & group practices 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1780602565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 TRANSIT AVE STE 202",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142544",
            "telephone_number": "770-721-8160",
            "fax_number": "770-721-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 TRANSIT AVE STE 202",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142544",
            "telephone_number": "770-721-8160",
            "fax_number": "770-721-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "WILLIAM",
        "middle_name": "ALLEN",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.