Individual provider Active NPI

Shayleigh Montgomery, FNP-C

  • Family Nurse Practitioner
  • Lewiston, ID
National Provider Identifier
1285466797
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
00 Issued in ID
Practice address
415 6TH Street
Lewiston, ID 83501
Phone
(208) 799-5226
Fax
(208) 799-5798
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 00 ID Primary

Addresses

Primary practice location

415 6TH Street
Lewiston, ID 83501

Mailing address

415 6TH St
Lewiston, ID 83501-2434
Phone (208) 799-5226

Other practice location 1

PO Box 3687
Coeur D Alene, ID 83816-2529
Phone (208) 819-2183

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909002918 ID Practitioner - Nurse Practitioner 8921548611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Hospital LLCGroup PAC ID 8325325806, 91 clinicians

Practice addresses (Care Compare)

415 6TH St
Lewiston, ID 83501-2431
Phone (208) 743-2511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meza Post Acute and Long Term Care, PLLC CurrentSince Sep 15, 2024 Accepting new patients
St Joseph Hospital LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

2426 N Merritt Creek Loop
Ste A
Coeur D Alene, ID 83814
Phone (208) 668-7000

821 21st Ave
Lewiston, ID 83501
Phone (208) 799-3422

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

3315 8th St
Lewiston, ID 83501
Phone (208) 743-9543

Interoperability endpoints

  • Direct secure messaging: shayleigh.montgomery.1@16883.direct.athenahealth.com

Organizations & group practices 2

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": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1285466797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012434",
            "telephone_number": "208-799-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH STREET",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "83501",
            "telephone_number": "208-799-5226",
            "fax_number": "208-799-5798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 3687",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838162529",
            "country_code": "US",
            "telephone_number": "208-819-2183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "SHAYLEIGH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.