Phyllis Blattstain Montellese, MD
Individual provider Active NPI Family Medicine Physician · Palmyra, VA
NPI 1366414385 · NPPES record last updated Aug 6, 2020
Key facts
- NPI
- 1366414385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101243771 (VA)
- Practice address
- 2599 Central Plains Rd
Palmyra, VA 22963 - Phone
- (434) 589-5658
- NPI assigned
- Feb 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101243771 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pefha Health & Wellness Center | Family Medicine | Past | Accepting new patients |
| Jules Kann M.D. and Malcolm Harris M.D, PC | Family Medicine | Past | Accepting new patients |
| Community Family Health Centers Inc | Past | Accepting new patients | |
| Upmc St. Margaret | Past | Accepting new patients |
Interoperability endpoints
- pmontellese246367@direct.sentara.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101243771 | VA | Yes |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 0101243771 | VA | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 0101243771 | VA |
Addresses
Primary practice location
2599 Central Plains Rd
Palmyra, VA 22963
Mailing address
2599 Central Plains Rd
Palmyra, VA 22963-4381
Phone (434) 589-5658
Other providers in Palmyra, VA
- Kristen Noel Maxwell
- John Maywalt
- Ryan McKinney
- Michael W McMurray
- Brendan Freeman McNulty
- Monticello Mobility LLC
- Cynthia Louise Moore
- Mallory Moore
- Susan J. Moore
- James E Moyer
All providers in Palmyra, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.