Blake Karlton Montgomery, MD

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

2023011215 Issued in MO

Practice address

1 Childrens PL
Ste 1B
Saint Louis, MO 63110-1002

Phone

(314) 514-3500

Fax

(314) 878-7678

NPI assigned

Apr 20, 2016

Last updated

Apr 17, 2025By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1275970295
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679516033
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Shriners Hospitals for Children

  dba Shriners Children's

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
  • NPI 1275271462
  NPD
• Shriners Hospitals for Children

  dba Shriners Children's Hawaii

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1104270610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-514-3500",
            "fax_number": "314-878-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "STE 1B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-514-3500",
            "fax_number": "314-878-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "BLAKE",
        "middle_name": "KARLTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2025-04-17",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "MO",
            "license": "2023011215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200124874",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Ste 1B",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grace Elizabeth Montes, MD
• Kevin Montes, MD
• Jessica Nicole Montgomery Mims, APRN, FNP-C
• Allison Montgomery, LCSW
• Andrea Jane Montgomery, AGNP
• Brett Montgomery
• Carrie Elizabeth Montgomery, DO
• Conal Christopher Montgomery, M.ED., LPC
• Jeanette Ruth Montgomery, C.N.P.
• Laura Anne Montgomery, LCSW

• Pediatric Orthopaedic Surgery Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatric Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.