Andre Lamont Montgomery, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3302 Issued in OH

Practice address

684 Avon Belden Rd
Suite B
Avon Lake, OH 44012-4110

Phone

(440) 930-5537

Fax

(440) 930-5237

NPI assigned

Apr 17, 2006

Last updated

Dec 8, 2020By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Montgomery Chiropractic Center IncGroup PAC ID 4981678117, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Montgomery Chiropractic Center Inc

  dba Montgomery Chiropractic Center

  • Chiropractor
  • Avon Lake, OH
  • NPI 1831155720
  Medicare reassignment Care Compare group NPD Authorized official
• Montgomery Chiropractic Center Inc

  • Durable Medical Equipment & Medical Supplies
  • Avon Lake, OH
  • NPI 1437816303
  Authorized official Same address or phone
• Starek Chiropractic Center

  • Chiropractor
  • Strongsville, OH
  • NPI 1861681280
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1457315202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 AVON BELDEN ROAD",
            "address_2": "SUITE B",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124111",
            "telephone_number": "440-930-5537",
            "fax_number": "440-930-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 AVON BELDEN RD",
            "address_2": "SUITE B",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124110",
            "telephone_number": "440-930-5537",
            "fax_number": "440-930-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ANDRE",
        "middle_name": "LAMONT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3302",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OH",
            "license": "3302",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2324167",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald J Mistur, PHD
• Farah Mohammad
• Robert Day Monroe, DPM
• Montgomery Chiropractic Center Inc
• Montgomery Chiropractic Center Inc (Montgomery Chiropractic Center)
• Melissa Moore
• Katelyn Ann Morris, OTR/L
• John C Mullins, OD
• Kelly Mulqueen, LISW
• Ervin Nallbani

• Chiropractor in Avon Lake, OH
• Providers in Avon Lake, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.