Individual provider Active NPI

Jennifer Danielle Montgomery, MSOTR/L

  • Occupational Therapist
  • Oxford, FL
National Provider Identifier
1104014133
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT18778 Issued in FL
Practice address
12120 County Road 103
Oxford, FL 34484-2987
Phone
(352) 230-1682
NPI assigned
Oct 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT18778 FL Primary

Addresses

Primary practice location

12120 County Road 103
Oxford, FL 34484-2987

Mailing address

13524 SE 101St Ter
Belleview, FL 34420-5583
Phone (352) 230-1682

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210105000245 FL Practitioner - Occupational Therapist in Private Practice 7810300266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Therapy FL, LLCGroup PAC ID 5890224463, 5 clinicians

Practice addresses (Care Compare)

12120 County Rd
Suite 103
Oxford, FL 34484-2987
Phone (352) 446-2143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
OT KR LLC Occupational Therapist CurrentSince Aug 1, 2021 Accepting new patients
Trinity Therapy FL, LLC CurrentSince Oct 12, 2024 Accepting new patients

Locations

200 Clearwater Largo Rd N
Largo, FL 33770
Phone (727) 544-1441

200 Clearwater Largo Rd S
Largo, FL 33770
Phone (727) 489-0857

3890 Woodridge Dr
The Villages, FL 32162
Phone (352) 674-3500

Organizations & group practices 2

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": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1104014133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13524 SE 101ST TER",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344205583",
            "telephone_number": "352-230-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12120 COUNTY ROAD 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842987",
            "telephone_number": "352-230-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JENNIFER",
        "middle_name": "DANIELLE",
        "credential": "MSOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT18778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.