Jason Robert Montgomery, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50001818 Issued in OH

Practice address

2405 N Columbus St Ste 200
Lancaster, OH 43130

Phone

(740) 687-5722

Fax

(740) 687-5898

NPI assigned

Jun 9, 2008

Last updated

Dec 16, 2009By the provider in NPPES

Sex

Male

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jmontgomery@avfm.ssdirect.aprima.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arbor View Family Medicine, Inc.

  • Preferred Provider Organization
  • Lancaster, OH
  • NPI 1285765008
  Medicare reassignment
• Fairfield Medical Center

  • Rural Health Clinic/Center
  • New Lexington, OH
  • NPI 1699496745
  NPD (past)

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1447410980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST STE 200",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "43130",
            "telephone_number": "740-687-5722",
            "fax_number": "740-687-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST STE 200",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "43130",
            "telephone_number": "740-687-5722",
            "fax_number": "740-687-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50001818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Paxton Mitchell, CNP
• MMS Columbus, Inc (Majors Medical Supply)
• Amelia Celeste Moats, DPT
• Joseph A Mong, LPC, CDCA
• Laura Elisabeth Mong, D.O.
• Chiemi Lea Moore, R.N.
• Jeffrey Lee Moore, DPM
• Madelyn Moore
• Madelyne Kristen Moore, LSW
• Payton Moore, LSW

• Physician Assistant in Lancaster, OH
• Providers in Lancaster, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.