Active NPI
Kevin M Montgomery, OT
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1497196166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 167765
- Practice address
- 946 Goss Ave Apt 5101
Louisville, KY 40217-2284 - Phone
- (270) 577-7045
- NPI assigned
- Jul 10, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31005502A | IN | |
| Occupational Therapist | 225X00000X | 167765 | KY | Primary |
Addresses
Primary practice location
946 Goss Ave Apt 5101
Louisville, KY 40217-2284
Mailing address
946 Goss Ave Apt 5101
Louisville, KY 40217-2284
Phone (270) 577-7045
Other practice location 1
225 Crosslake Dr
Evansville, IN 47715-8198
Phone (812) 477-1558
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31005502A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prorehab at Vincennes, LLC | Past | Accepting new patients | |
| Prorehab Inc | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapy Clinic/Center
- Vincennes, IN
- NPI 1750494787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1497196166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "946 GOSS AVE APT 5101",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402172284",
"telephone_number": "270-577-7045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "946 GOSS AVE APT 5101",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402172284",
"telephone_number": "270-577-7045"
}
],
"practiceLocations": [
{
"address_1": "225 Crosslake Dr",
"address_purpose": "LOCATION",
"city": "Evansville",
"state": "IN",
"postal_code": "477158198",
"country_code": "US",
"telephone_number": "812-477-1558",
"fax_number": "812-474-2296",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "KEVIN",
"middle_name": "M",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-10",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31005502A",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "167765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.