Individual provider Active NPI

Montgomery Davis

  • Certified Registered Nurse Anesthetist
  • College Station, TX
National Provider Identifier
1265029284
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024195693 Issued in VA
Practice address
700 Scott and White Dr
College Station, TX 77845-6441
Phone
(979) 207-0100
Fax
(979) 207-2161
NPI assigned
Dec 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1031057 TX
Certified Registered Nurse Anesthetist 367500000X 0024195693 VA Primary
Nurse Practitioner 363L00000X R099213 AR
Certified Registered Nurse Anesthetist 367500000X 1031057 AR

Addresses

Primary practice location

700 Scott and White Dr
College Station, TX 77845-6441

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371

Other practice location 1

53 Meadow Ridge Loop
Maumelle, AR 72113-6879
Phone (870) 718-4194

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdavis1477073@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, HI, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210512000548 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608285291 Reassigns benefits to 4 organizations
I20241205003524 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608285291 Reassigns benefits to 1 organization
I20260513000420 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608285291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians
Pacific Anesthesia IncGroup PAC ID 1951596329, 108 clinicians
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians

Practice addresses (Care Compare)

1280 Arrington Rd
Suite 200
College Station, TX 77845-8696
Phone (979) 207-6550

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 691-1000

1700 University Dr E
College Station, TX 77840-2661
Phone (979) 691-3300

1700 University Dr E Entrance 16
Care Clinic College Station University Dr
College Station, TX 77840-2661
Phone (979) 207-3636

830 Kempsville Rd
Norfolk, VA 23502-3920
Phone (757) 261-6000

Hospital & facility affiliations

  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Baylor Scott & White Medical Center- College Stati Hospital, College Station, TX, CCN 670088
  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R099213ARMDNurse Practitioner
1031057ARMDCertified Registered Nurse Anesthetist
1031057TXMDCertified Registered Nurse Anesthetist
0024195693VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Nov 17, 2025 Accepting new patients
Pacific Anesthesia, Inc CurrentSince Nov 27, 2024 Accepting new patients
Scott & White Clinic CurrentSince Nov 17, 2025 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2021 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 12, 2025 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Dec 10, 2025 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

321 N Kuakini St
Ste 306
Honolulu, HI 96817
Phone (808) 545-1557

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002

700 Scott and White Dr
College Station, TX 77845
Phone (979) 207-0100

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: mdavis1477073@direct.sw.org

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1265029284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371",
            "fax_number": "254-215-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SCOTT AND WHITE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456441",
            "telephone_number": "979-207-0100",
            "fax_number": "979-207-2161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53 Meadow Ridge Loop",
            "address_purpose": "LOCATION",
            "city": "Maumelle",
            "state": "AR",
            "postal_code": "721136879",
            "country_code": "US",
            "telephone_number": "870-718-4194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MONTGOMERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-23",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1031057",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024195693",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "R099213",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "1031057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdavis1477073@direct.sw.org",
            "affiliation": "N",
            "endpointDescription": "mdavis1477073@direct.sw.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "700 SCOTT AND WHITE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778456441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.