Jayme Kenna Montgomery, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

113779 Issued in OK

Practice address

705 W Oakland St
Broken Arrow, OK 74012-1656

Phone

(918) 251-2666

NPI assigned

Jun 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Broken Arrow Family Clinic IncGroup PAC ID 1153588355, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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.

• Broken Arrow Family Clinic Inc

  • Family Medicine Physician
  • Broken Arrow, OK
  • NPI 1497966303
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1559347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559347200000",
    "number": "1518525849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8505 E 132ND ST S",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740083306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W OAKLAND ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740121656",
            "telephone_number": "918-251-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JAYME",
        "middle_name": "KENNA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-01",
        "last_updated": "2019-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "113779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Monette, DPH
• Robert Blaine Mongrain Jr., DMD
• Bradley Russell Mons, D.O.
• Christine Anna Monteith, LCSW, LADC/MH
• Racheal Megan Montgomery-Garba, M.S. CCC-SLP
• Moonlit Mental Health LLC
• Angela Moore, B.S.
• Dawn Michelle Moore, B.H.R.S.
• Lori Lynn Moore, COTA/L
• Mariana Jocelyn Moore

• Family Nurse Practitioner in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.