Penelope Montgomery

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

857656 Issued in MS

Practice address

391 Southcrest Cir Ste 200
Southaven, MS 38671-6729

Phone

(901) 271-1000

Fax

(662) 996-1209

NPI assigned

Sep 2, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1154230688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIR STE 200",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716729",
            "telephone_number": "901-271-1000",
            "fax_number": "662-996-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIR STE 200",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716729",
            "telephone_number": "901-271-1000",
            "fax_number": "662-996-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "PENELOPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "857656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Mitchell, LMSW
• Tracey Mitchell, M.ED., NCC
• Terry L Mix, DPH
• Modern Vascular of Southaven, LLC
• Pamela Michelle Molck, CPNP-PC
• Rena D Montgomery, APN
• Lacey Moody
• Moore Speech Therapy, LLC
• Anna Moore
• Apryl Suzanne Moore, SLP

• Registered Nurse in Southaven, MS
• Providers in Southaven, MS by specialty
• Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.