Individual provider Active NPI

Kathryn Montgomery, DPT

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1326636242
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT38291 Issued in FL
Practice address
4268 Oldfield Crossing Dr Ste 201
Jacksonville, FL 32223-8800
Phone
(904) 634-0640
Fax
(904) 634-0203
NPI assigned
Jan 6, 2021
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12097 SC
Physical Therapist 225100000X 046598-01 NY
Physical Therapist 225100000X PT38291 FL Primary

Addresses

Primary practice location

4268 Oldfield Crossing Dr Ste 201
Jacksonville, FL 32223-8800

Mailing address

12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618
Phone (904) 886-3228

Other practice location 1

6871 Belfort Oaks Pl Ste 200
Jacksonville, FL 32216-6242
Phone (904) 886-3228

Other practice location 2

216 Southpark Cir E Ste 216
St Augustine, FL 32086-5135
Phone (904) 634-0640

Other practice location 3

4565 US Highway 17 Ste 200
Fleming Island, FL 32003-4823
Phone (904) 634-0640

Other practice location 4

15255 Max Legget Pkwy Ste 5300
Jacksonville, FL 32218-7274
Phone (904) 634-0640

Other practice location 5

8599 A C Skinner Pkwy Unit 5215
Jacksonville, FL 32256-0863
Phone (717) 307-5029

Other practice location 6

12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618
Phone (904) 886-3228

Other practice location 7

10475 Centurion Pkwy N Ste 220
Jacksonville, FL 32256-5004
Phone (904) 634-0640

Other practice location 8

3055 County Road 210 W Ste 110
St Johns, FL 32259-7001
Phone (904) 634-0640

Other practice location 9

2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762
Phone (904) 634-0640

Other practice location 10

1690 US Highway 1 S Ste 1
St Augustine, FL 32084-4192
Phone (904) 634-0640

Other practice location 11

232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone (904) 634-0640

Other practice location 12

2627 Riverside Ave # 605
Jacksonville, FL 32204-4717
Phone (904) 634-0640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231028000196 FL Practitioner - Physical Therapist in Private Practice 4082060942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.75 of 100Reported as group
Quality
88.19
Promoting interoperability
100
Improvement activities
40
Cost
80.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12097SCMDClinical Social Worker
046598-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Me: Physical Therapy & Coaching LLC CurrentSince Nov 19, 2023 Accepting new patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Oct 25, 2023 Accepting new patients
Southeast Orthopedic Specialists, LLC CurrentSince Oct 30, 2023 Accepting new patients
Southeast Orthopedic Specialists, LLC CurrentSince Oct 30, 2023 Accepting new patients

Locations

4565 US Highway 17
Ste 200
Fleming Island, FL 32003
Phone (904) 630-0640

10475 Centurion Pkwy N
Ste 220
Jacksonville, FL 32256
Phone 9046340640 ext. 1014

15255 Max Leggett Pkwy
Ste 5300
Jacksonville, FL 32218
Phone (904) 203-1386

2 Shircliff Way
Ste 605
Jacksonville, FL 32204
Phone (904) 328-5979

2627 Riverside Ave
#605
Jacksonville, FL 32204

4268 Oldfield Crossing Dr
Ste 201
Jacksonville, FL 32223
Phone (904) 630-0640

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

6800 Southpoint Pkwy
Ste 300
Jacksonville, FL 32216
Phone (904) 674-2023

232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082
Phone (904) 285-7546

1690 US Highway 1 S
Ste 1
Saint Augustine, FL 32084

216 Southpark Cir E
Ste 216
St Augustine, FL 32086
Phone (904) 634-0460

3055 County Road 210 W
Ste 110
St Johns, FL 32259
Phone (904) 634-0203

Organizations & group practices 4

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": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1326636242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD STE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238618",
            "telephone_number": "904-886-3228",
            "fax_number": "904-485-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4268 OLDFIELD CROSSING DR STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238800",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6871 Belfort Oaks Pl Ste 200",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322166242",
            "country_code": "US",
            "telephone_number": "904-886-3228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Southpark Cir E Ste 216",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865135",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4565 US Highway 17 Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320034823",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 Max Legget Pkwy Ste 5300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322187274",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8599 A C Skinner Pkwy Unit 5215",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322560863",
            "country_code": "US",
            "telephone_number": "717-307-5029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12276 San Jose Blvd Ste 508",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322238618",
            "country_code": "US",
            "telephone_number": "904-886-3228",
            "fax_number": "904-485-8876",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10475 Centurion Pkwy N Ste 220",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322565004",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3055 County Road 210 W Ste 110",
            "address_purpose": "LOCATION",
            "city": "St Johns",
            "state": "FL",
            "postal_code": "322597001",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Shircliff Way Ste 605",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044762",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1690 US Highway 1 S Ste 1",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320844192",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 Ponte Vedra Park Dr",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra Beach",
            "state": "FL",
            "postal_code": "320826600",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2627 Riverside Ave # 605",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044717",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KATHRYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12097",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046598-01",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.