Individual provider Active NPI

Cari Nicole Montgomery, L.C.S.W.

  • Clinical Social Worker
  • Noblesville, IN
National Provider Identifier
1417972506
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005703A Issued in IN
Practice address
23 S 8TH St
Noblesville, IN 46060-2632
Phone
(317) 674-3160
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-011229 IL
Clinical Social Worker 1041C0700X 34005703A IN Primary

Addresses

Primary practice location

23 S 8TH St
Noblesville, IN 46060-2632

Mailing address

4913 Graceland Ave
Indianapolis, IN 46208-3426
Phone (317) 721-1166

Other practice location 1

12337 Hancock St
Ste 20
Carmel, IN 46032-5885
Phone (317) 706-6744

Other identifiers 3

IdentifierTypeStateIssuer
201163980MedicaidIN
201178980AMedicaidIN
IN1231OtherINMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160509001321 IN Practitioner - Clinical Social Worker 3375842636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-011229ILMDClinical Social Worker
34005703AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Therapeutic Services LLC. Clinical CurrentSince Jun 26, 2017 Accepting new patients
Emerald Neuro-Recover PastSince Feb 11, 2020 Accepting new patients

Locations

200 Medical Dr
Ste D
Carmel, IN 46032
Phone (317) 207-0010

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417972506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 GRACELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462083426",
            "telephone_number": "317-721-1166",
            "fax_number": "317-663-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S 8TH ST",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602632",
            "telephone_number": "317-674-3160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12337 Hancock St",
            "address_2": "Ste 20",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460325885",
            "country_code": "US",
            "telephone_number": "317-706-6744",
            "fax_number": "317-706-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "CARI",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-011229",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005703A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201163980",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201178980A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "IN1231",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

Verify at the official NPI Registry.