Individual provider Active NPI

Alexandria Nicole Montgomery, DNP

  • Advanced Practice Midwife
  • Charlotte, NC
National Provider Identifier
1366695496
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
552 Issued in NC
Practice address
1718 E 4TH St Ste 907
Charlotte, NC 28204-3282
Phone
(043) 724-0007
Fax
(704) 334-4855
NPI assigned
Nov 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 202276 NC
Women's Health Nurse Practitioner 363LW0102X 5006564 NC
Advanced Practice Midwife 367A00000X 552 NC Primary

Addresses

Primary practice location

1718 E 4TH St Ste 907
Charlotte, NC 28204-3282

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 372-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amontgomery194433@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421001655 NC Practitioner - Certified Nurse Midwife (CNM) 4789902826 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
202276NCMDRegistered Nurse
552NCMDFoot & Ankle Surgery Podiatrist
5006564NCMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince May 3, 2018 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 3, 2018 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients

Locations

1718 E 4th St
Ste 907
Charlotte, NC 28204
Phone (704) 372-4000

911 W Henderson St
Ste 300
Salisbury, NC 28144
Phone (704) 636-9270

Interoperability endpoints

  • Direct secure messaging: amontgomery194433@direct.novanthealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1366695496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-372-4000",
            "fax_number": "704-334-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST STE 907",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043282",
            "telephone_number": "043-724-0007",
            "fax_number": "704-334-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ALEXANDRIA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "202276",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NC",
            "license": "5006564",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NC",
            "license": "552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amontgomery194433@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1718 E 4th St Ste 907",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.