Individual provider Active NPI

John Paul Montana

  • Pharmacist
  • Wichita, KS
National Provider Identifier
1497159248
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
115011 Issued in KS
Practice address
1313 N Maize CT
#208
Wichita, KS 67212-4388
Phone
(316) 721-5036
Fax
(316) 721-1705
NPI assigned
Oct 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 115011 KS Primary

Addresses

Primary practice location

1313 N Maize CT
#208
Wichita, KS 67212-4388

Mailing address

1313 N Maize CT
#208
Wichita, KS 67212-4388
Phone (316) 721-5036

Other identifiers 1

IdentifierTypeStateIssuer
115011MedicaidKS

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

State licenses

LicenseStateTypeSpecialty
115011KSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1497159248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 N MAIZE CT",
            "address_2": "#208",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124388",
            "telephone_number": "316-721-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 N MAIZE CT",
            "address_2": "#208",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124388",
            "telephone_number": "316-721-5036",
            "fax_number": "316-721-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANA",
        "first_name": "JOHN PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "115011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115011",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.