Kymberlee A Montgomery, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

VP003479G Issued in PA

Practice address

216 N Broad St
4TH Floor
Philadelphia, PA 19102-1121

Phone

(215) 762-3600

Fax

(215) 762-4323

NPI assigned

Jan 23, 2007

Last updated

Oct 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberlee A Elles Former name

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kennedy Medical Group Practice, P.C.

  dba Jefferson Health

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796
  Medicare reassignment Care Compare group NPD
• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment NPD
• Methodist Associates in Healthcare, Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053355131
  Medicare reassignment NPD
• Drexel University

  dba Drexel University Healthcare Services

  • Nurse Practitioner
  • Philadelphia, PA
  • NPI 1821403734
  NPD
• Methodist Associates in Healthcare, Inc

  dba Jefferson Community Physicians - Neurosurgery

  • Neurological Surgery Physician
  • Philadelphia, PA
  • NPI 1790390813
  NPD
• Methodist Associates in Healthcare, Inc.

  dba Jefferson Community Physicians - Kairys

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1033575352
  NPD
• Kennedy Medical Group P.C.

  dba kennedy Health Alliance

  • Psychologist
  • Voorhees, NJ
  • NPI 1609314004
  NPD
• Kennedy Medical Group Practice PC

  dba Kennedy Health Alliance

  • Family Medicine Physician
  • Sewell, NJ
  • NPI 1952848905
  NPD
• Philadelphia Health & Education Corp

  dba Drexel Infertility Svcs

  • Reproductive Endocrinology Physician
  • Philadelphia, PA
  • NPI 1326192337
  NPD (past)
• Philadelphia Health & Education Corporation

  dba Drexel Gynecology-Oncology Services

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1356496038
  NPD (past)
• Philadelphia Health & Education Corp

  dba Drexel Cardiology NJ

  • Cardiovascular Disease Physician
  • Marlton, NJ
  • NPI 1467597054
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  Care Compare affiliation

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1033264007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST STE 1012",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191021320",
            "telephone_number": "267-359-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N BROAD ST",
            "address_2": "4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-3600",
            "fax_number": "215-762-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KYMBERLEE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "VP003479G",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN295794L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEE",
            "last_name": "ELLES",
            "middle_name": "A",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charissa Montgomery
• Erica Lynn Montgomery, MD
• Jessica Rae Montgomery, LMHC, LPC
• Kathleen Anne Montgomery, CRNP
• Kelly Montgomery, MD
• Lakeshia Montgomery
• Lawrence Purves Montgomery III, DDS
• Marie Denise Montgomery, PH.D
• Matthew Harold Montgomery, D.O.
• Michelle L Montgomery

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.