Janessa Annette Montgomery, DNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

C154761 Issued in IA

Practice address

5510 Utica Ridge Rd
Davenport, IA 52807-2946

Phone

(563) 424-2025

NPI assigned

Oct 2, 2019

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

Other identifiers 1

Other names 1

• Janessa Annette Freeman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jmontgomery931632@direct.unitypoint.org

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.

• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Quad Cities Pediatrics, P.C.

  • Primary Care Clinic/Center
  • Davenport, IA
  • NPI 1174818447
  NPD (past)

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1225679012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 ROCK RIDGE RD NW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524055307",
            "telephone_number": "319-389-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 UTICA RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072946",
            "telephone_number": "563-424-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JANESSA",
        "middle_name": "ANNETTE",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C154761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C154761",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANESSA",
            "last_name": "FREEMAN",
            "middle_name": "ANNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meagan Moller, MA, ATR, LCPC, LMHC
• Kelly Elizabeth Molloy
• Monica'S Psychotherapy and Healing, PLLC
• Monogram Health Professional Services of Iowa PLLC
• Jade Montgomery
• Mandy Moody
• J D Moon, DDS
• Rebecca Lynn Moonen, DPT
• Brianna Mooney, BCBA
• Kevin Joel Moore, DC

• Pediatric Nurse Practitioner in Davenport, IA
• Providers in Davenport, IA by specialty
• Pediatric Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.