Active NPI
Ava Montgomery
- Case Manager/Care Coordinator
- Shreveport, LA
National Provider Identifier
1477051126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 2920 Knight St Ste 110
Shreveport, LA 71105-2412 - Phone
- (318) 670-7047
- NPI assigned
- Jan 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | LA | Primary |
Addresses
Primary practice location
2920 Knight St Ste 110
Shreveport, LA 71105-2412
Mailing address
2920 Knight St Ste 110
Shreveport, LA 71105-2412
Other practice location 1
Changing Behaviors Act Team
1440 Hawn Avenue
Shreveport, LA 71107
Phone (318) 226-5990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CBS Act Center LLC | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527033600000",
"number": "1477051126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2920 KNIGHT ST STE 110",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711052412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 KNIGHT ST STE 110",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711052412",
"telephone_number": "318-670-7047"
}
],
"practiceLocations": [
{
"address_1": "Changing Behaviors Act Team",
"address_2": "1440 Hawn Avenue",
"address_purpose": "LOCATION",
"city": "Shreveport",
"state": "LA",
"postal_code": "71107",
"country_code": "US",
"telephone_number": "318-226-5990",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "AVA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-29",
"last_updated": "2018-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.