Jason Montgomery, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3167 Issued in CO

Practice address

3750 N Briarwood LN
Muncie, IN 47304

Phone

(765) 213-6373

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Comprehensive Pain and Spine Specialists LLC

  • Interventional Pain Medicine Physician
  • Muncie, IN
  • NPI 1497426050
  NPD
• Emergency Physicians of Delaware County, P.C.

  • Emergency Medicine Physician
  • Muncie, IN
  • NPI 1417956384
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Robert E. Wright MD, PC

  • Pain Medicine (Anesthesiology) Physician
  • Greenwood Village, CO
  • NPI 1750339123

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1104835594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 N BRIARWOOD LN",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47304",
            "telephone_number": "765-213-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 N BRIARWOOD LN",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47304",
            "telephone_number": "765-213-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JASON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-10-20",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000879A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3167",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zakaria Fuad Mohamed, MD
• Rushikesh Ravindra Mohite, PT
• Julie Mongeri-McPherson
• Monroe TWP. / Cowan Volunteer Fire Department, Inc.
• Matthew Wayne Monroe, RN
• Amber Moody, LMHC
• Amanda Moore, LPN
• Fonda Moore
• Jalea Moore
• Jaliyah Moore

• Medical Physician Assistant in Muncie, IN
• Providers in Muncie, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.