Ismari Montanez

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

22663 Issued in TN

Practice address

362 Callen LN NW
Suite 110
Cleveland, TN 37312-3784

Phone

(423) 331-5025

Fax

(423) 698-0511

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ECFEAA

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.

• Fertility Brilliance

  • Clinic/Center
  • Omaha, NE
  • NPI 1942007125
  NPD (past)
• Trillion Health and Hormone Clinic

  • General Practice Physician
  • Omaha, NE
  • NPI 1013576057
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1306965926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2072",
            "city": "COLLEGEDALE",
            "state": "TN",
            "postal_code": "373152072",
            "telephone_number": "423-227-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 CALLEN LN NW",
            "address_2": "SUITE 110",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123784",
            "telephone_number": "423-331-5025",
            "fax_number": "423-698-0511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4957 Swinyar Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ooltewah",
            "state": "TN",
            "postal_code": "373632205",
            "country_code": "US",
            "telephone_number": "423-362-7777",
            "fax_number": "423-362-7778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "281 N Lyerly St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374042728",
            "country_code": "US",
            "telephone_number": "423-698-0850",
            "fax_number": "423-698-0511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9527 W Ridge Trail Rd",
            "address_purpose": "LOCATION",
            "city": "Soddy Daisy",
            "state": "TN",
            "postal_code": "373794018",
            "country_code": "US",
            "telephone_number": "423-842-3031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTANEZ",
        "first_name": "ISMARI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000147736",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "22663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q029115",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kalee Ann Miracle
• Brian C Mitchell, MD
• Jayden O Mitchell
• Savannah Mitchell
• Katie Lauren Monroe
• Edgar Scott Monterde, CRNA
• Jaclyn Nicole Montgomery, APRN, FNP-BC
• Sarah Ellena Montgomery, LPC/MHSP
• Flora Padhmavathy Moodley
• Angela Nichole Moody, FNP-C

• Nurse Practitioner in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.