Individual provider Active NPI

Dominic Montalto, OT

  • Occupational Therapist
  • Lewisburg, TN
National Provider Identifier
1205616208
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7809 Issued in TN
Practice address
712 N Ellington Pkwy Ste 6
Lewisburg, TN 37091-2454
Phone
(931) 359-1913
NPI assigned
Oct 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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 7809 TN Primary

Addresses

Primary practice location

712 N Ellington Pkwy Ste 6
Lewisburg, TN 37091-2454

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231023000377 TN Practitioner - Occupational Therapist in Private Practice 1759737117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLCGroup PAC ID 4486066396, 390 clinicians

Practice addresses (Care Compare)

712 N Ellington Pkwy
Suite 6
Lewisburg, TN 37091-2454
Phone (931) 359-1913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7809TNMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Results-Ast JV, LLC Occupational Therapist CurrentSince Oct 16, 2023 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

712 N Ellington Pkwy
Ste 6
Lewisburg, TN 37091
Phone (931) 359-1913

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Organizations & group practices 1

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": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1205616208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N ELLINGTON PKWY STE 6",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370912454",
            "telephone_number": "931-359-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALTO",
        "first_name": "DOMINIC",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "7809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.