Erica Shere' Montgomery, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1-136193 Issued in AL

Practice address

256 Honeysuckle Rd Ste 3
Dothan, AL 36305-1168

Phone

(334) 350-5648

NPI assigned

Jan 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Erica Shere' Ellis Former name

Medicare fee-for-service enrollment

Enrolled in AL

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Central Alabama Mental Health Board IncGroup PAC ID 7517856024, 8 clinicians

River Region Psychiatry Associates, LLCGroup PAC ID 1254491012, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• River Region Psychiatry Associates LLC

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1386891497
  Medicare reassignment Care Compare group NPD
• South Central Alabama Mental Health Board Inc

  • Community/Behavioral Health Agency
  • Andalusia, AL
  • NPI 1194866905
  Medicare reassignment Care Compare group NPD
• Mind Over Matter LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Opp, AL
  • NPI 1700402955
  NPD

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

{
    "created_epoch": "1547337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1053885012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 HONEYSUCKLE RD STE 3",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051168",
            "telephone_number": "334-350-5648",
            "fax_number": "334-640-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 HONEYSUCKLE RD STE 3",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051168",
            "telephone_number": "334-350-5648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 N Main St",
            "address_purpose": "LOCATION",
            "city": "Opp",
            "state": "AL",
            "postal_code": "364671626",
            "country_code": "US",
            "telephone_number": "334-493-3541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ERICA",
        "middle_name": "SHERE'",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-13",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-136193",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-136193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "ELLIS",
            "middle_name": "SHERE'",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.