Jerry Montgomery, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

876366 Issued in NY

Practice address

2811 Queens PLZ N
Long Island City, NY 11101-4172

Phone

(718) 391-8300

NPI assigned

Oct 31, 2024

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1225851074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LOGAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014259",
            "telephone_number": "347-328-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 QUEENS PLZ N",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014172",
            "telephone_number": "718-391-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JERRY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "876366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlie Monlouis Anderle, CD, CBC
• Rachel Beth Montag
• Gandhy Magally Montalvo Rosales, MD
• Bruna Monteau, RN
• Maria Montes, LMHC
• Stephanie J Moon
• Sanna A Moore, LCSW
• Ana Morales, LCSW, MPA
• John Morales, PTA
• Madeline L Morales

• General Practice Registered Nurse in Long Island City, NY
• Providers in Long Island City, NY by specialty
• General Practice Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.