Active NPI
Aimee Montgomery
- Physician Assistant
- Fort Worth, TX
National Provider Identifier
1396176293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA08762
- Practice address
- 7001 Granbury Rd
Fort Worth, TX 76133-5912 - Phone
- (817) 346-1925
- Fax
- (817) 292-7237
- NPI assigned
- Dec 3, 2013
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA08762 | TX | Primary |
Addresses
Primary practice location
7001 Granbury Rd
Fort Worth, TX 76133-5912
Mailing address
7001 Granbury Rd
Fort Worth, TX 76133-5912
Phone (817) 346-1925
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 332534201 | Medicaid | TX |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA08762 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1396176293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7001 GRANBURY RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761335912",
"telephone_number": "817-346-1925",
"fax_number": "817-292-7237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7001 GRANBURY RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761335912",
"telephone_number": "817-346-1925",
"fax_number": "817-292-7237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "AIMEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-03",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA08762",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "332534201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.