Loretta L Montgomery, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

155920 Issued in TN

Practice address

4700 Mueller Brass Rd
Covington, TN 38019-3754

Phone

(901) 476-0235

Fax

(901) 476-0229

NPI assigned

Jan 31, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Loretta L Montgomery Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1043718448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 MUELLER BRASS RD",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193754",
            "telephone_number": "901-476-0235",
            "fax_number": "901-476-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MUELLER BRASS RD",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193754",
            "telephone_number": "901-476-0235",
            "fax_number": "901-476-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "LORETTA",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "155920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TIPTION COUNTY HEALTH DEPT",
            "identifier": "00507441",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORETTA",
            "last_name": "MONTGOMERY",
            "middle_name": "L",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Frank Lester Miller III
• Tyriniesha L Milton
• Ella M Mitchell
• Kailyn Mitchell
• Qiana Mitchell
• Leila Dione Moore, PHARM.D.
• Gloria Q Morgan
• Kara L Morgan
• Robert Morrison, PTA
• Carolyn Jean Morton, O.D.

• Registered Nurse in Covington, TN
• Providers in Covington, TN by specialty
• Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.