Individual provider Active NPI

Devery Montano, CNM, RN

  • Advanced Practice Midwife
  • Oceanside, CA
National Provider Identifier
1083067979
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
235756 Issued in CA
Practice address
148 Harrison St
Oceanside, CA 92057-4440
Phone
(352) 870-6451
NPI assigned
Jul 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 235756 CA Primary

Addresses

Primary practice location

148 Harrison St
Oceanside, CA 92057-4440

Mailing address

148 Harrison St
Oceanside, CA 92057-4440
Phone (352) 870-6451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160912002615 CA Practitioner - Certified Nurse Midwife (CNM) 5698061927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Registered Nurse

State licenses

LicenseStateTypeSpecialty
235756CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mendocino Community Health Clinic, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Ukiah Adventist Hospital Past Accepting new patients
Mendocino Community Health Clinic, Inc. Past Accepting new patients

Locations

333 Laws Ave
Ukiah, CA 95482
Phone (707) 463-1113

Interoperability endpoints

  • Direct secure messaging: dmontano335499@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1083067979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 HARRISON ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920574440",
            "telephone_number": "352-870-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 HARRISON ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920574440",
            "telephone_number": "352-870-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANO",
        "first_name": "DEVERY",
        "name_prefix": "Mrs.",
        "credential": "CNM, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.