Active NPI
Cynthia Gail Montgomery, MD
- Specialist
- Shreveport, LA
National Provider Identifier
1376521823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 06971R
- Practice address
- 2508 Bert Kouns Loop
Suite 401
Shreveport, LA 71118-3133 - Phone
- (318) 686-5440
- Fax
- (318) 686-0624
- NPI assigned
- Jan 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 06971R | LA | Primary |
Addresses
Primary practice location
2508 Bert Kouns Loop
Suite 401
Shreveport, LA 71118-3133
Mailing address
2508 Bert Kouns Loop
Suite 401
Shreveport, LA 71118-3133
Phone (318) 686-5440
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1378062 | Medicaid | LA | |
| 8082TU | Other | TX | BCBS OF TX |
| 29417 | Other | LA | BCBS OF LA |
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 |
|---|---|---|---|
| 06971R | LA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376521823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2508 BERT KOUNS LOOP",
"address_2": "SUITE 401",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183133",
"telephone_number": "318-686-5440",
"fax_number": "318-686-0624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2508 BERT KOUNS LOOP",
"address_2": "SUITE 401",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183133",
"telephone_number": "318-686-5440",
"fax_number": "318-686-0624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "CYNTHIA",
"middle_name": "GAIL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "LA",
"license": "06971R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1378062",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TX",
"identifier": "8082TU",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF LA",
"identifier": "29417",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.