Emmett Fulcher Montgomery, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35242 Issued in NC

Practice address

104 Knox CT Ste 100
Davidson, NC 28036-0590

Phone

(704) 892-5454

Fax

(704) 892-5858

NPI assigned

Sep 22, 2005

Last updated

Dec 20, 2022By the provider in NPPES

Sex

Male

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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emmett.montgomery.1@14667.direct.athenahealth.com
• Direct secure messaging: emmett.montgomery.1@29681.direct.athenahealth.com

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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  Medicare reassignment Care Compare group NPD
• Afc Urgent Care and Family Care of WNC, PLLC

  dba Afc Urgent Care

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1679066658
  Medicare reassignment NPD
• Advanced Healthcare

  • Family Medicine Physician
  • Mooresville, NC
  • NPI 1124084702
  NPD (past) Authorized official

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1356337646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4329",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280364329",
            "telephone_number": "704-892-5454",
            "fax_number": "704-892-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 KNOX CT STE 100",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280360590",
            "telephone_number": "704-892-5454",
            "fax_number": "704-892-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 E Statesville Ave",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281152598",
            "country_code": "US",
            "telephone_number": "704-663-5056",
            "fax_number": "704-663-5780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "EMMETT",
        "middle_name": "FULCHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "35242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Eiserman Miller, M.A. CCC SLP
• Modernday Wellness PLLC
• Bryn Mohn, BS
• Moliver Chiropractic, PLLC
• Seth Loren Moliver, D.C.
• Rebecca Piles Montgomery, MD
• Lauren Mook, OTR/L
• Alyssa Morelli, ATC
• Kathleen McMahon Morris, PA-C
• Ms Rapid Answers, LLC

• Family Medicine Physician in Davidson, NC
• Providers in Davidson, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.