C. Ted Montgomery, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME10755 Issued in FL

Practice address

3550 University Blvd S
Ste 301
Jacksonville, FL 32216-4225

Phone

(904) 384-2240

Fax

(904) 448-0030

NPI assigned

Jun 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• North East Florida Endocrine and Diabetes Assoc PA

  • Customized Equipment (DME)
  • Jacksonville, FL
  • NPI 1992070585
  NPD (past)

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1093717159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST",
            "address_2": "STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240",
            "fax_number": "904-448-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 UNIVERSITY BLVD S",
            "address_2": "STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164225",
            "telephone_number": "904-384-2240",
            "fax_number": "904-448-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "C.",
        "middle_name": "TED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME10755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371200100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Montesinos Counseling Services, LLC
• Steven Montesinos, MA, LMHC
• Nichole Montez
• Rebecca Clerisse Montfleury
• Anna Grace Montford, M.ED. CF-SLP
• Carter Montgomery, LMHC
• Ciara L Montgomery
• Darian Montgomery
• Derriyah Montgomery
• John Michael Montgomery, MD

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.