Individual provider Active NPI

Penny Ann Montgomery, LVN

  • Licensed Vocational Nurse
  • Corpus Christi, TX
National Provider Identifier
1003319823
Registry record updated Mar 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
179415 Issued in TX
Practice address
800 N Shoreline Blvd Ste 700
Corpus Christi, TX 78401-3771
Phone
(361) 937-7887
NPI assigned
Mar 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 179415 TX Primary

Addresses

Primary practice location

800 N Shoreline Blvd Ste 700
Corpus Christi, TX 78401-3771

Mailing address

PO Box 973
Ingleside, TX 78362-0973
Phone (361) 446-1070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
179415TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Homestyle Specialty Nursing Care, Inc Past Accepting new patients

Organizations & group practices 1

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": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521331200000",
    "number": "1003319823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 973",
            "city": "INGLESIDE",
            "state": "TX",
            "postal_code": "783620973",
            "telephone_number": "361-446-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N SHORELINE BLVD STE 700",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784013771",
            "telephone_number": "361-937-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "PENNY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-18",
        "last_updated": "2018-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "179415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.