Individual provider Active NPI

Ashley Howard Montcalm, NP-C

  • Family Nurse Practitioner
  • Smyrna, GA
National Provider Identifier
1063760684
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN181675 Issued in GA
Practice address
4441 Atlanta Rd SE Ste 206
Smyrna, GA 30080-6442
Phone
(770) 333-2020
Fax
(770) 333-2023
NPI assigned
Aug 29, 2012
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN181675 GA Primary

Addresses

Primary practice location

4441 Atlanta Rd SE Ste 206
Smyrna, GA 30080-6442

Mailing address

4441 Atlanta Rd SE Ste 206
Smyrna, GA 30080-6442
Phone (770) 333-2020

Other practice location 1

210 Clover Reach
Peachtree City, GA 30269-1657
Phone (770) 487-9604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20210318000797 GA Practitioner - Nurse Practitioner 5294142212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1700 Hospital S Dr
Austell, GA 30106-8159

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN181675GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Apr 15, 2021 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Peachtree City Obstetrics and Gynecology, P.C. Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

4441 Atlanta Rd SE
Ste 206
Smyrna, GA 30080
Phone (770) 333-2020

Interoperability endpoints

  • Direct secure messaging: amontcalm413695@directwellstar.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.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1063760684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 ATLANTA RD SE STE 206",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806442",
            "telephone_number": "770-333-2020",
            "fax_number": "770-333-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 ATLANTA RD SE STE 206",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806442",
            "telephone_number": "770-333-2020",
            "fax_number": "770-333-2023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Clover Reach",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302691657",
            "country_code": "US",
            "telephone_number": "770-487-9604",
            "fax_number": "770-631-0540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTCALM",
        "first_name": "ASHLEY",
        "middle_name": "HOWARD",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN181675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.