Individual provider Active NPI

Brianna Kay Montross, MS, RD, LD

  • Registered Dietitian
  • Coralville, IA
National Provider Identifier
1396585626
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
110871 Issued in IA
Practice address
105 E 9TH St
Coralville, IA 52241-2209
Phone
(319) 467-2000
NPI assigned
May 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 110871 IA Primary

Addresses

Primary practice location

105 E 9TH St
Coralville, IA 52241-2209

Mailing address

817 Hughes St
Coralville, IA 52241-2143
Phone (515) 402-9674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240706000272 IA Practitioner - Registered Dietitian Or Nutrition Professional 0547704173 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
110871IAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Jun 10, 2024 Accepting new patients

Locations

105 E 9th St
Iowa City, IA 52241
Phone (319) 467-2000

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

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": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1396585626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 HUGHES ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412143",
            "telephone_number": "515-402-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E 9TH ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412209",
            "telephone_number": "319-467-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTROSS",
        "first_name": "BRIANNA",
        "middle_name": "KAY",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "110871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.