Active NPI
Terry L Montague, MD
- Diagnostic Radiology Physician
- St George, UT
National Provider Identifier
1356367536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 174855-1205
- Practice address
- 1380 E Medical Center Dr
St George, UT 84790-2123 - Phone
- (435) 688-4000
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 174855-1205 | UT | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 11253 | NV | |
| Body Imaging Physician | 2085B0100X | 174855-1205 | UT | |
| Diagnostic Neuroimaging (Radiology) Physician | 2085D0003X | 174855-1205 | UT |
Addresses
Primary practice location
1380 E Medical Center Dr
St George, UT 84790-2123
Mailing address
283 E 930 S
Orem, UT 84058-5001
Phone (801) 225-6246
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107007775101 | Other | UT | IHC |
| 907907 | Other | UT | DMBA |
| 870487570004 | Medicaid | UT | |
| 59284499602001 | Other | UT | BLUE CROSS |
| 870487570MD1 | Other | UT | EMIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11253 | NV | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312156800000",
"number": "1356367536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "283 E 930 S",
"city": "OREM",
"state": "UT",
"postal_code": "840585001",
"telephone_number": "801-225-6246",
"fax_number": "801-225-1525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1380 E MEDICAL CENTER DR",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847902123",
"telephone_number": "435-688-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTAGUE",
"first_name": "TERRY",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2011-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "UT",
"license": "174855-1205",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NV",
"license": "11253",
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "UT",
"license": "174855-1205",
"primary": false
},
{
"code": "2085D0003X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Neuroimaging",
"state": "UT",
"license": "174855-1205",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107007775101",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMBA",
"identifier": "907907",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "870487570004",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "59284499602001",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMIA",
"identifier": "870487570MD1",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.