McKensie S Montgomery

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

P-0065 Issued in NM

Practice address

405 W Country Club Rd
Roswell, NM 88201-5209

Phone

(575) 624-8170

NPI assigned

Mar 16, 2011

Last updated

Mar 16, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1427357441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W COUNTRY CLUB RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015209",
            "telephone_number": "575-624-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W COUNTRY CLUB RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015209",
            "telephone_number": "575-624-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "MCKENSIE",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "P-0065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ankita Mishra, MD
• Mission Arch Operator LLC
• Saneal Mistry, DDS
• Michael J. Mitchell, M.D.
• Yanet Montelongo, LMSW
• Stephen W Montgomery, MD
• Erin Jeanette Montgomery,, LMFT, LSAA
• Lorene Montoya
• Tonia Elizabeth Montoya, FNP-C
• Vanessa Montoya, M.A. CF-SLP

• Registered Dietitian in Roswell, NM
• Providers in Roswell, NM by specialty
• Registered Dietitian in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.