Individual provider Active NPI

Hollie Raye Gentry, DNP, MSN

  • Women's Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1992562144
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
26NJ15015900 Issued in NJ
Practice address
65 Bergen St
Newark, NJ 07107-3001
Phone
(973) 972-4307
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 26NJ15015900 NJ Primary

Addresses

Primary practice location

65 Bergen St
Newark, NJ 07107-3001

Mailing address

7 Cobblestone LN
Annandale, NJ 08801-2024
Phone (440) 453-0954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240429002279 NJ Practitioner - Nurse Practitioner 5597105213 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15015900NJMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince May 1, 2024 Accepting new patients
University Hospital CurrentSince Aug 4, 2024 Accepting new patients
University Hospital CurrentSince Aug 4, 2024 Accepting new patients

Locations

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

140 Bergen St
#F1776
Newark, NJ 07103
Phone (973) 972-3282

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1992562144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 COBBLESTONE LN",
            "city": "ANNANDALE",
            "state": "NJ",
            "postal_code": "088012024",
            "telephone_number": "440-453-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073001",
            "telephone_number": "973-972-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "HOLLIE",
        "middle_name": "RAYE",
        "credential": "DNP, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NJ15015900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.