Active NPI
Averie Montgomery-Diener, PTA, LMT
- Physical Therapy Assistant
- Santa Fe, NM
National Provider Identifier
1033623780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A-1328
- Practice address
- 2538 Camino Entrad Suite 300
Santa Fe, NM 87507 - Phone
- (505) 424-1239
- NPI assigned
- Nov 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 4837 | NM | |
| Physical Therapy Assistant | 225200000X | A-1328 | NM | Primary |
Addresses
Primary practice location
2538 Camino Entrad Suite 300
Santa Fe, NM 87507
Mailing address
2538 Camino Entrada Ste 300
Santa Fe, NM 87507-4927
Phone (505) 424-1239
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
| License | State | Type | Specialty |
|---|---|---|---|
| A-1328 | NM | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spine Solutions, 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.
-
- Orthopedic Physical Therapist
- Santa Fe, NM
- NPI 1144496472
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524441600000",
"number": "1033623780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2538 CAMINO ENTRADA STE 300",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875074927",
"telephone_number": "505-424-1239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2538 CAMINO ENTRAD SUITE 300",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87507",
"telephone_number": "505-424-1239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY-DIENER",
"first_name": "AVERIE",
"credential": "PTA, LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-16",
"last_updated": "2018-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "4837",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NM",
"license": "A-1328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.