Individual provider Active NPI

Mitchell Samonte Montemayor

  • Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
  • Charlotte, NC
National Provider Identifier
1225517758
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081H0002X
License
P9549 Issued in NC
Practice address
17328 Newlands Corner LN
Charlotte, NC 28277-2480
Phone
(704) 585-7733
Fax
(704) 585-7733
NPI assigned
Aug 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician 2081H0002X P9549 NC Primary

Addresses

Primary practice location

17328 Newlands Corner LN
Charlotte, NC 28277-2480

Mailing address

17328 Newlands Corner LN
Charlotte, NC 28277-2480
Phone (704) 585-7733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P9549NCMDHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1225517758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17328 NEWLANDS CORNER LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772480",
            "telephone_number": "704-585-7733",
            "fax_number": "704-585-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17328 NEWLANDS CORNER LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772480",
            "telephone_number": "704-585-7733",
            "fax_number": "704-585-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEMAYOR",
        "first_name": "MITCHELL",
        "middle_name": "SAMONTE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081H0002X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "P9549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.