Individual provider Active NPI

James Claffy Montgomery Jr., M.D.

  • Gynecology Physician
  • Murrells Inlet, SC
National Provider Identifier
1225071806
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
8192 Issued in SC
Practice address
4518 Richmond Hill Dr
Murrells Inlet, SC 29576-6818
Phone
(843) 908-3229
Fax
(843) 947-0513
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 8192 SC Primary

Addresses

Primary practice location

4518 Richmond Hill Dr
Murrells Inlet, SC 29576-6818

Mailing address

4518 Richmond Hill Dr
Murrells Inlet, SC 29576-6818
Phone (843) 908-3229

Other identifiers 1

IdentifierTypeStateIssuer
081921MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122001558 SC Practitioner - Obstetrics/Gynecology 9537185756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical University of South Carolina College of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Infusion Services LLCGroup PAC ID 4688578826, 60 clinicians

Practice addresses (Care Compare)

1027 Physicians Dr
Suite 220
Charleston, SC 29414-5352
Phone (803) 771-7740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3180SCMDChiropractor
8192SCMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Infusion Services LLC CurrentSince Oct 1, 2016 Accepting new patients
Florida Department of Health Past Accepting new patients
Florida Department of Health PastSince Oct 1, 2000 Accepting new patients

Locations

1027 Physicians Dr
Ste 220
Charleston, SC 29414
Phone (843) 553-7588

139 Willbrook Blvd
Unit A
Pawleys Island, SC 29585
Phone (843) 979-4100

Organizations & group practices 3

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1225071806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4518 RICHMOND HILL DR",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295766818",
            "telephone_number": "843-908-3229",
            "fax_number": "843-947-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4518 RICHMOND HILL DR",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295766818",
            "telephone_number": "843-908-3229",
            "fax_number": "843-947-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JAMES",
        "middle_name": "CLAFFY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "SC",
            "license": "8192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081921",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

Verify at the official NPI Registry.