NPIMap

Individual provider Active NPI

Jenna Raye Montano, APRN

  • Acute Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1053162768
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4016956 Issued in KY
Practice address
210 E Gray St
Louisville, KY 40202-3900
Phone
(502) 559-3636
NPI assigned
Mar 29, 2024
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4016956 KY Primary

Addresses

Primary practice location

210 E Gray St
Louisville, KY 40202-3900

Mailing address

7405 Pine Knoll Cir
Prospect, KY 40059-9259
Phone (502) 432-7559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240507003941 KY Practitioner - Nurse Practitioner 4587005632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

2355 Poplar Level Rd
Suite 301
Louisville, KY 40217-1388
Phone (502) 636-0406

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4016956KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Single Specialty Current Accepting new patients
Community Medical Associates, Inc. Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Jun 1, 2024 Accepting new patients

Locations

210 E Gray St
Ste 605
Louisville, KY 40202
Phone (502) 559-3636

2355 Poplar Level Rd
Ste 301
Louisville, KY 40217
Phone (502) 559-3636

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: jmontano125788@direct.nortonhealthcare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1053162768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 PINE KNOLL CIR",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599259",
            "telephone_number": "502-432-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E GRAY ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023900",
            "telephone_number": "502-559-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANO",
        "first_name": "JENNA",
        "middle_name": "RAYE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4016956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.