Individual provider Active NPI

Kristen D Montgomery

  • Licensed Practical Nurse
  • Jackson, OH
National Provider Identifier
1518818848
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.192002 Issued in OH
Practice address
219 Columbia St
Jackson, OH 45640-1771
Phone
(740) 577-9003
Fax
(740) 577-9184
NPI assigned
Feb 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X LPN.192002 OH Primary

Addresses

Primary practice location

219 Columbia St
Jackson, OH 45640-1771

Mailing address

219 Columbia St
Jackson, OH 45640-1771
Phone (740) 577-9003

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
LPN.192002OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Center, Inc. Single Specialty Past Accepting new patients
Phoenix Center, Inc. Single Specialty 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1518818848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 COLUMBIA ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401771",
            "telephone_number": "740-577-9003",
            "fax_number": "740-577-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 COLUMBIA ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401771",
            "telephone_number": "740-577-9003",
            "fax_number": "740-577-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KRISTEN",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.192002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.