Mark Earl Montgomery, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1030517 Issued in TX

Practice address

14515 Omicron Dr.
San Antonio, TX 78245-3225

Phone

(210) 688-2406

NPI assigned

Feb 20, 2021

Last updated

Sep 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Services of TX, PLLCGroup PAC ID 3375909351, 374 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment Care Compare group NPD
• Bexar County Emergency Services District Number Two

  • Land Ambulance
  • San Antonio, TX
  • NPI 1548823263
  NPD Authorized official

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

{
    "created_epoch": "1613779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1326632365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11830 SHOTGUN WAY",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234438",
            "telephone_number": "210-268-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14515 OMICRON DR.",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782453225",
            "telephone_number": "210-688-2406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11830 Shotgun Way",
            "address_purpose": "LOCATION",
            "city": "Helotes",
            "state": "TX",
            "postal_code": "780234438",
            "country_code": "US",
            "telephone_number": "210-268-7591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "MARK",
        "middle_name": "EARL",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1030517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1030517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee Dejarna Montgomery
• Comfort Montgomery
• Jennifer Leigh Montgomery, AUD
• Linda M Montgomery, PH.D.
• Marica Montgomery, DVM
• Mercedes Autumn Montgomery
• Michael Todd Montgomery, DDS
• Shyra Donee Montgomery, BSN, RN
• Janie Alejandra Montiel, MS, LMFT
• Katheryn Faye Montiel

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.