Individual provider Active NPI

Benjamin M Gentry, PA

  • Medical Physician Assistant
  • Augusta, GA
National Provider Identifier
1811246317
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2346 Issued in GA
Practice address
701 Greene St Ste 200
Augusta, GA 30901-2385
Phone
(706) 722-6900
Fax
(706) 722-5118
NPI assigned
Aug 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2346 GA Primary

Addresses

Primary practice location

701 Greene St Ste 200
Augusta, GA 30901-2385

Mailing address

701 Greene St Ste 200
Augusta, GA 30901-2385
Phone (706) 722-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 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
I20121016000453 GA Practitioner - Physician Assistant 5092965772 Reassigns benefits to 1 organization
I20130325000569 SC Practitioner - Physician Assistant 5092965772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates PCGroup PAC ID 4880682368, 19 clinicians

Practice addresses (Care Compare)

1109 Medical Ctr Dr
Augusta, GA 30909-6633
Phone (706) 860-9220

1355 Independence Dr
Augusta, GA 30901-1037
Phone (706) 826-5857

1815 Wylds Rd
Augusta, GA 30909-4430
Phone (706) 733-0522

398 Town Park Blvd
Suite a
Evans, GA 30809-3435
Phone (706) 619-1264

Hospital & facility affiliations

  • Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2346GAMDProfessional Counselor
1885SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Renal Physicians, P.C. PastSince Jul 15, 2020 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1811246317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 GREENE ST STE 200",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012385",
            "telephone_number": "706-722-6900",
            "fax_number": "706-722-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GREENE ST STE 200",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012385",
            "telephone_number": "706-722-6900",
            "fax_number": "706-722-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "BENJAMIN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-30",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "2346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.