Individual provider Active NPI

Leslie Ann-Sikes Montgomery, FNP

  • Family Nurse Practitioner
  • Whitney, TX
National Provider Identifier
1003405945
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1027093 Issued in TX
Practice address
1314 N Brazos St
Whitney, TX 76692-2010
Phone
(254) 694-3621
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1027093 TX Primary

Addresses

Primary practice location

1314 N Brazos St
Whitney, TX 76692-2010

Mailing address

1314 N Brazos St
Whitney, TX 76692-2010
Phone (254) 694-3621

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
I20210222002080 TX Practitioner - Nurse Practitioner 1254329691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Randall Henderson, D.O. PLLC 6 clinicians

Practice addresses (Care Compare)

1314 N Brazos St
Whitney, TX 76692-2010
Phone (254) 694-3621

Hospital & facility affiliations

  • Ascension Providence Hospital, Waco, TX, CCN 450042
  • Hill Regional Hospital Hospital, Hillsboro, TX, CCN 451395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Randall Henderson, D.O. PLLC CurrentSince Jan 29, 2021 Accepting new patients

Locations

1314 N Brazos St
Whitney, TX 76692
Phone (254) 694-3621

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/hillreg-be6e9ad0

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.

Hospital & facility affiliations 2

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": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1003405945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 N BRAZOS ST",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922010",
            "telephone_number": "254-694-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 N BRAZOS ST",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922010",
            "telephone_number": "254-694-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "LESLIE",
        "middle_name": "ANN-SIKES",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1027093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitney, TX

Sources for this page

Verify at the official NPI Registry.