Individual provider Active NPI

Richard A. Montgomery, M.D.

  • Psychiatry Physician
  • Caldwell, ID
National Provider Identifier
1275567638
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M-9072 Issued in ID
Practice address
1906 Fairview Ave Ste 220
Caldwell, ID 83605-5432
Phone
(208) 795-5072
NPI assigned
Jul 10, 2006
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X M-9072 ID Primary

Addresses

Primary practice location

1906 Fairview Ave Ste 220
Caldwell, ID 83605-5432

Mailing address

PO Box 277976
Atlanta, GA 30384-7976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20040819001078 ID Practitioner - Psychiatry 3476527169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Valley Medical Group LLCGroup PAC ID 8729180310, 9 clinicians

Practice addresses (Care Compare)

1906 Fairview Ave
Suite 220
Caldwell, ID 83605-5432
Phone (208) 459-4667

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Arthritis & Osteoporosis Center PC CurrentSince Mar 13, 2023 Accepting new patients
West Valley Medical Group LLC CurrentSince Mar 13, 2023 Accepting new patients
Eastern Idaho Health Services Inc Past Accepting new patients
West Valley Medical Group Specialty Services LLC Past Accepting new patients
Ascent Behavioral Health Services Past Accepting new patients
Eastern Idaho Health Services Inc Past Accepting new patients
West Valley Medical Center, Inc. Past Accepting new patients

Locations

1906 Fairview Ave
Ste 220
Caldwell, ID 83605
Phone (208) 795-5072

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

745 S Progress Ave
Ste 120
Meridian, ID 83642
Phone (208) 795-5073

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: richard.montgomery@hca3.eclinicaldirectplus.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1275567638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277976",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 220",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055432",
            "telephone_number": "208-795-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "RICHARD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M-9072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.