Susan Leigh Montgomery, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R524174 Issued in MS

Practice address

122 Weisenberger Road
Madison, MS 39110-8561

Phone

(601) 790-9080

Fax

(601) 790-9098

NPI assigned

Jun 24, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Raleigh Family Health Clinic PLLC

  • Primary Care Clinic/Center
  • Bay Springs, MS
  • NPI 1497173942
  NPD (past)
• River Oaks Management Company LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1922029040
  NPD (past)

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296691200000",
    "number": "1447561345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 WEISENBERGER ROAD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108561",
            "telephone_number": "601-790-9080",
            "fax_number": "601-790-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 WEISENBERGER ROAD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108561",
            "telephone_number": "601-790-9080",
            "fax_number": "601-790-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "SUSAN",
        "middle_name": "LEIGH",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2011-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R524174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116067",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Moncure
• Montgomery Family Clinic
• Erin Britton Montgomery, D.M.D., M.S.D
• Joseph Brooks Montgomery, MD
• Latrena Montgomery, FNP-C
• Elizabeth Bryce Mooney, PT
• Ellen Peyton Moore, DNP, APRN, AGPCNP-BC
• Lee Ellis Moore, M.D.
• Morgan Moore, NP
• More MD LLC

• Family Nurse Practitioner in Madison, MS
• Providers in Madison, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.