Individual provider Active NPI

Stephanie Marie Montgomery

  • Family Nurse Practitioner
  • Easton, MD
National Provider Identifier
1467981787
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R189729 Issued in MD
Practice address
219 S Washington St
Easton, MD 21601-2913
Phone
(410) 310-6245
NPI assigned
Jun 9, 2017
Last updated
Jun 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R189729 MD Primary

Addresses

Primary practice location

219 S Washington St
Easton, MD 21601-2913

Mailing address

305 Devon Dr
Chestertown, MD 21620-3366
Phone (202) 257-7712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20171116002257 MD Practitioner - Nurse Practitioner 7810253317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
DRS Shanahan and Ferguson PCGroup PAC ID 3476445396, 6 clinicians

Practice addresses (Care Compare)

120 Speer Rd
BLDG B
Chestertown, MD 21620-1044
Phone (410) 778-9300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.13 of 100Reported as apm
Quality
90.26
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay River Primary Care PC CurrentSince Sep 30, 2019 Accepting new patients
Shore-Bayy Hospitalists Associates CurrentSince Aug 7, 2017 Accepting new patients
Shore Hospitalists Associates P.a. PastSince Aug 7, 2017 Accepting new patients

Locations

120 Speer Rd
Bldg B
Chestertown, MD 21620
Phone (410) 778-9300

219 S Washington St
Easton, MD 21601

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1467981787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 DEVON DR",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216203366",
            "telephone_number": "202-257-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 S WASHINGTON ST",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012913",
            "telephone_number": "410-310-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R189729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.