Individual provider Active NPI

Lisa Christine Montbellier, PA

  • Physician Assistant
  • Roswell, GA
National Provider Identifier
1003070491
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002403 Issued in GA
Practice address
1380 Upper Hembree Rd
Roswell, GA 30076-1146
Phone
(770) 475-2377
Fax
(770) 442-0193
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002403 GA Primary

Addresses

Primary practice location

1380 Upper Hembree Rd
Roswell, GA 30076-1146

Mailing address

1380 Upper Hembree Rd
Roswell, GA 30076-1146
Phone (770) 475-2377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140723002345 GA Practitioner - Physician Assistant 5395961551 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002403GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health Choice Urgent Care, LLC CurrentSince Sep 15, 2020 Accepting new patients
Health Choice Urgent Care, LLC CurrentSince Sep 15, 2020 Accepting new patients

Locations

2690 Hamilton Mill Rd
Ste 100
Buford, GA 30519
Phone (470) 326-7300

660 W Crossville Rd
Ste 110
Roswell, GA 30075
Phone (770) 649-0711

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDCFBA/Endpoint/EDCFBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/EDCFBA

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.

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1003070491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 UPPER HEMBREE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761146",
            "telephone_number": "770-475-2377",
            "fax_number": "770-442-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 UPPER HEMBREE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761146",
            "telephone_number": "770-475-2377",
            "fax_number": "770-442-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTBELLIER",
        "first_name": "LISA",
        "middle_name": "CHRISTINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.