NPIMap

Organization Active NPI

Montgomery Surgery Associates LLC

  • Cardiovascular Disease Physician
  • Blacksburg, VA
National Provider Identifier
1366486664
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MONTGOMERY SURGERY ASSOCIATES LLC
Practice address
830 Hospital Dr
Blacksburg, VA 24060-7023
Phone
(540) 961-1591
NPI assigned
Jun 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Authorized official

Name
Kenneth Washington
Title
VP
Phone
(703) 650-2907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

830 Hospital Dr
Blacksburg, VA 24060-7023

Mailing address

830 Hospital Dr
Blacksburg, VA 24060-7023
Phone (540) 961-1591

Other identifiers 3

IdentifierTypeStateIssuer
1366486664MedicaidVA
DE2036OtherRR MEDICARE
3810003897MedicaidWV

National Provider Directory

National Provider Directory

Locations

830 Davis St
Ste 1
Blacksburg, VA 24060
Phone (540) 443-7400

817 Davis St
Blacksburg, VA 24060
Phone (540) 522-3670

809 Davis St
#1
Blacksburg, VA 24060
Phone (540) 951-0780

801 Davis St
Ste 2
Blacksburg, VA 24060
Phone (540) 961-0149

801 Davis St
Ste 1
Blacksburg, VA 24060
Phone (540) 961-0218

809 Davis St
Ste B
Blacksburg, VA 24060

830 Davis St
Blacksburg, VA 24060
Phone (540) 381-0344

3610 S Main St
Blacksburg, VA 24060
Phone (540) 443-6111

809 Davis St
Ste A
Blacksburg, VA 24060

614 E Main St
Ste A
Radford, VA 24141
Phone (540) 443-0500

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1366486664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 HOSPITAL DR",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607023",
            "telephone_number": "540-961-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HOSPITAL DR",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607023",
            "telephone_number": "540-961-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY SURGERY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "703-650-2907"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366486664",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DE2036",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003897",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.