Individual provider Active NPI

Ashlee Montgomery, FNP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1538781216
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27442 Issued in TN
Practice address
407 Highland Ave
Johnson City, TN 37604-6109
Phone
(423) 943-3886
NPI assigned
May 15, 2020
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27442 TN Primary

Addresses

Primary practice location

407 Highland Ave
Johnson City, TN 37604-6109

Mailing address

407 Highland Ave
Johnson City, TN 37604-6109
Phone (423) 943-3886

Other names 1

  • Ashlee Elizabeth Whaley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20200717000164 TN Practitioner - Nurse Practitioner 6002230562 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Pac Healthcare Services of Tennessee PCGroup PAC ID 0840587572, 74 clinicians
NV Pacs 2 LLCGroup PAC ID 0941550578, 119 clinicians

Practice addresses (Care Compare)

701 W Main Blvd
Church Hill, TN 37642-3915
Phone (423) 357-7178

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
NV Pacs 2 LLC CurrentSince Jan 3, 2024 Accepting new patients
Ipc Pac Healthcare Services of Tennessee PC CurrentSince Jan 3, 2024 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Sep 14, 2024 Accepting new patients

Locations

701 W Main Blvd
Church Hill, TN 37642
Phone (423) 357-7178

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

2035 E Stonebrook Pl
Kingsport, TN 37660
Phone (423) 224-3660

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1538781216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 HIGHLAND AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046109",
            "telephone_number": "423-943-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 HIGHLAND AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046109",
            "telephone_number": "423-943-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ASHLEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEE",
            "last_name": "WHALEY",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.