Active NPI
Crystal Brook Montgomery-Bunney, MSHA, RD/LD
- Registered Dietitian
- Claremore, OK
National Provider Identifier
1285716803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1312
- Practice address
- 15336 E 470 Rd
Claremore, OK 74017-5372 - Phone
- (918) 557-0022
- NPI assigned
- Oct 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1312 | OK | Primary |
Addresses
Primary practice location
15336 E 470 Rd
Claremore, OK 74017-5372
Mailing address
15336 E 470 Rd
Claremore, OK 74017-5372
Phone (918) 557-0022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1312 | OK | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Core, LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285716803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15336 E 470 RD",
"city": "CLAREMORE",
"state": "OK",
"postal_code": "740175372",
"telephone_number": "918-557-0022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15336 E 470 RD",
"city": "CLAREMORE",
"state": "OK",
"postal_code": "740175372",
"telephone_number": "918-557-0022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY-BUNNEY",
"first_name": "CRYSTAL",
"middle_name": "BROOK",
"credential": "MSHA, RD/LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Claremore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.