Diana Michelle Montgomery, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A01699 Issued in AR

Practice address

305 W. Main Street
Nea Baptist Clinic
Trumann, AR 72472

Phone

(870) 483-6131

Fax

(870) 483-2573

NPI assigned

Jun 16, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Merit-based Incentive Payment System (MIPS)

Final score

75.65 of 100Reported as group

Quality

44.87

Promoting interoperability

100

Improvement activities

40

Cost

73.98

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmontgomery29735@direct.bmhcc.org

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.

• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
  • NPI 1861721839

  AR

  Medicare reassignment NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Mobile Mammography Clinic/Center
  • Jonesboro, AR
  • NPI 1417721689
  NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Clinical Medical Laboratory
  • Jonesboro, AR
  • NPI 1801127030
  NPD
• White River Health System, Inc.

  • Primary Care Clinic/Center
  • Cherokee Village, AR
  • NPI 1508846015
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1457356347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "address_2": "NEA BAPTIST CLINIC",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-483-6131",
            "fax_number": "870-483-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W. MAIN STREET",
            "address_2": "NEA BAPTIST CLINIC",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "72472",
            "telephone_number": "870-483-6131",
            "fax_number": "870-483-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "DIANA",
        "middle_name": "MICHELLE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A01699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150983758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miracle Kids Success Academy of Trumann
• Miracle Kids Success Academy of Trumann
• Miracle Kids Success Academy of Trumann
• Andrea Jordan Monreal
• Brooklyn Montgomery, LCSW
• Kimberly Moody
• Taylor Patrick Moore, LPC
• Karen D Morris
• Muse Family Practice
• Leigh Edwards Nance, LMSW

• All providers in Trumann, AR
• Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.
• 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.