Individual provider Active NPI

Donna E Bradley-Gentry, MSN, FNP

  • Family Nurse Practitioner
  • Rockwall, TX
National Provider Identifier
1942221445
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
575062 Issued in TX
Practice address
890 Rockwall Pkwy Ste 100
Rockwall, TX 75032-6871
Phone
(214) 771-3712
Fax
(214) 771-3796
NPI assigned
Jul 21, 2006
Last updated
Jan 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 575062 TX
Family Nurse Practitioner 363LF0000X 575062 TX Primary

Addresses

Primary practice location

890 Rockwall Pkwy Ste 100
Rockwall, TX 75032-6871

Mailing address

890 Rockwall Pkwy Ste 100
Rockwall, TX 75032-6871
Phone (214) 771-3712

Other identifiers 1

IdentifierTypeStateIssuer
8N4488OtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040308000920 TX Practitioner - Nurse Practitioner 7911895321 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jun 24, 2022 Accepting new patients
Healthtexas Provider Network CurrentSince Jun 24, 2022 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Sparks Clinic PA PastSince Sep 6, 2006 Accepting new patients

Locations

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

200 N Virginia St
Terrell, TX 75160
Phone 97255174007500

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, 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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1942221445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 ROCKWALL PKWY STE 100",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326871",
            "telephone_number": "214-771-3712",
            "fax_number": "214-771-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 ROCKWALL PKWY STE 100",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326871",
            "telephone_number": "214-771-3712",
            "fax_number": "214-771-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY-GENTRY",
        "first_name": "DONNA",
        "middle_name": "E",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "575062",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "575062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8N4488",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.