Latrena Montgomery, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R881572 Issued in MS

Practice address

105 Varese PL
Madison, MS 39110

Phone

(601) 622-8182

NPI assigned

Jun 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hephzibah Visiting CliniciansGroup PAC ID 1254688641, 11 clinicians

Segue Health of Texas PLLCGroup PAC ID 8921400953, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BFGEDD
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Hephzibah Visiting Clinicians

  • Family Nurse Practitioner
  • Desoto, TX
  • NPI 1083101075
  Medicare reassignment Care Compare group NPD
• Segue Health of Texas PLLC

  • Family Medicine Physician
  • Azle, TX
  • NPI 1215510763
  Medicare reassignment Care Compare group NPD
• App of Mississippi Ed, LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1730687740
  Medicare reassignment NPD
• Jackson HB Medical Services LLC

  dba Merit Health Central

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1184305856
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Yazoo Emergency Group, LLC

  • Emergency Medicine Physician
  • Yazoo City, MS
  • NPI 1447806914
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • Family Medicine Physician
  • Lexington, MS
  • NPI 1013020395
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• G a Carmichael Family Health Center. Inc.

  • Federally Qualified Health Center (FQHC)
  • Yazoo City, MS
  • NPI 1548327463
  NPD (past)
• Beulah Family Clinic Professional Limited Liability Company

  • Clinic/Center
  • Desoto, TX
  • NPI 1750144150
  NPD (past)

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1346621075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1668 W PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465332",
            "telephone_number": "601-622-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VARESE PL",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110",
            "telephone_number": "601-622-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "LATRENA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R881572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Mize
• Tiffany Moncure
• Montgomery Family Clinic
• Erin Britton Montgomery, D.M.D., M.S.D
• Joseph Brooks Montgomery, MD
• Susan Leigh Montgomery, FNP
• Elizabeth Bryce Mooney, PT
• Ellen Peyton Moore, DNP, APRN, AGPCNP-BC
• Lee Ellis Moore, M.D.
• Morgan Moore, NP

• Family Nurse Practitioner in Madison, MS
• Providers in Madison, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.