Individual provider Active NPI

Irma Elena Montemayor, M.D.

  • General Practice Physician
  • Del Rio, TX
National Provider Identifier
1386704054
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
K2539 Issued in TX
Practice address
106 Foster Dr
Del Rio, TX 78840-2757
Phone
(830) 778-8442
Fax
(830) 778-8321
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X K2539 TX Primary

Addresses

Primary practice location

106 Foster Dr
Del Rio, TX 78840-2757

Mailing address

PO Box 420847
106 Foster Drive
Del Rio, TX 78842-0847
Phone (830) 778-8442

Other identifiers 1

IdentifierTypeStateIssuer
80511YOtherTXBLUE CROSS BLUE SHIELDS #

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

LicenseStateTypeSpecialty
K2539TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Health Clinic CurrentSince Jul 1, 2012 Accepting new patients

Locations

106 Foster Dr
Del Rio, TX 78840
Phone (830) 778-8442

Organizations & group practices 1

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386704054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420847",
            "address_2": "106 FOSTER DRIVE",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788420847",
            "telephone_number": "830-778-8442",
            "fax_number": "830-778-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 FOSTER DR",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788402757",
            "telephone_number": "830-778-8442",
            "fax_number": "830-778-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEMAYOR",
        "first_name": "IRMA",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "K2539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELDS #",
            "identifier": "80511Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Rio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.