Dean Parker Montgomery Jr., PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

575 Issued in OK

Practice address

100 W 7TH St
Okmulgee, OK 74447-5007

Phone

(918) 758-1910

Fax

(918) 756-1270

NPI assigned

Oct 4, 2006

Last updated

Jul 16, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1033204763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 471556",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741471556",
            "telephone_number": "918-250-6805",
            "fax_number": "918-250-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 7TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744475007",
            "telephone_number": "918-758-1910",
            "fax_number": "918-756-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "DEAN",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100840530A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "731229233002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.