Mary Montgomery, MSCCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22006383A Issued in IN

Practice address

333 State St
Newburgh, IN 47630-1231

Phone

(812) 773-8321

NPI assigned

Oct 12, 2016

Last updated

Oct 12, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brainpower Neurodevelopmental Center, LLC

  • Psychologist
  • Newburgh, IN
  • NPI 1023462413
  NPD (past)

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1447700695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 BALMORAL DR",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202587",
            "telephone_number": "502-541-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 STATE ST",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476301231",
            "telephone_number": "812-773-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "MARY",
        "credential": "MSCCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22006383A",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "KY-2547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott E Mitchell, PA-C
• Grace Moberly
• Justine Moesner, FNP
• Clifton Mominee
• Julie Katherine Monahan, PT
• Amber Gaye Moore
• David C Moore, M.D.
• Elizabeth Moore, PA-C
• Madalyn Moore, RBT
• Madeline Moore

• Speech-Language Pathologist in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.