Montgomery Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

6058 T2973 Issued in OH

Legal business name

MONTGOMERY EYE CARE, LLC

Doing business as

Amazing Eyes Family Vision

Practice address

11 Woodlake TRL
Mount Vernon, OH 43050-8113

Phone

(740) 326-1190

Fax

(740) 326-9753

NPI assigned

Feb 27, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Amanda Montgomery, ODNPI 1417236803

Title

Owner

Phone

(740) 326-1190

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amazing Eyes Family Vision Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Montgomery, O.D.

  • Optometrist
  • Mount Vernon, OH
  • NPI 1417236803
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1407120140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WOODLAKE TRL",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430508113",
            "telephone_number": "740-326-1190",
            "fax_number": "740-326-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WOODLAKE TRL",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430508113",
            "telephone_number": "740-326-1190",
            "fax_number": "740-326-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-326-1190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6058 T2973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157421",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amazing Eyes Family Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Amazing Eyes Family Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin Paul Momeyer
• Monroe Township Knox County Oh (Monroe Township Fire Department)
• Mirna Monroy-Cubie, COTA/L
• John P Montenery, R.PH.
• Mary Lou Montenery, R.PH.
• Amanda Montgomery, O.D.
• Laurie A Mooney, MD
• Anthony Moore, CDCA
• Bobbi Moore
• Heather Lynn Moore, RPH

• Optometrist in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.