Individual provider Active NPI

Akua Rosia Montgomery, NP-C

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1508329541
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5011724 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-2426
Phone
(336) 716-4650
Fax
(336) 716-4318
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5011724 NC
Family Nurse Practitioner 363LF0000X 0024177912 VA
Nurse Practitioner 363L00000X 5011724 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-2426

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-4650

Other practice location 1

501 Rison St Ste 120
Danville, VA 24541-2426
Phone (434) 792-3730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200623001920 NC Practitioner - Nurse Practitioner 2769714419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Sioux City College of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5011724NCMDFamily Nurse Practitioner
0024177912VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jan 1, 2022 Accepting new patients
Central Piedmont Health Services, Inc PastSince Aug 4, 2019 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
Memorial Family Care PastSince Aug 1, 2019 Accepting new patients

Locations

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: amontgomery2753588@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1508329541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-4650",
            "fax_number": "336-716-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271572426",
            "telephone_number": "336-716-4650",
            "fax_number": "336-716-4318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Rison St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "VA",
            "postal_code": "245412426",
            "country_code": "US",
            "telephone_number": "434-792-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "AKUA",
        "middle_name": "ROSIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011724",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177912",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.