Holly Ann Montgomery, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E-10823 Issued in AR

Practice address

1525 Country Club Road
Sherwood, AR 72120-5076

Phone

(501) 758-1530

Fax

(501) 819-6171

NPI assigned

Apr 15, 2014

Last updated

Jul 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Holly Ann Hargrove Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: holly.montgomery.1@17087.direct.athenahealth.com

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.

• The Pediatric Clinic of NLR, P.a.

  dba The Pediatric Clinic

  • Medical Specialty Clinic/Center
  • Sherwood, AR
  • NPI 1588692198
  NPD (past)
• The Pediatric Clinic of NLR, P.a.

  dba The Pediatric Clinic

  • Medical Specialty Clinic/Center
  • Cabot, AR
  • NPI 1669146346
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1609295922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 COUNTRY CLUB ROAD",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205076",
            "telephone_number": "501-758-1530",
            "fax_number": "501-819-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 COUNTRY CLUB ROAD",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205076",
            "telephone_number": "501-758-1530",
            "fax_number": "501-819-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-10823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "HARGROVE",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donald C Mitchell, BA, MHPP
• Tracy R Mitchell
• Brigette A Mocan, MD
• Momentum Therapeutic Services
• Caroline Louise Montague, OT
• Amanda Leigh Moore
• Chelsey Marie Moore
• Hallie Rene Moore
• Kyjana Dominique Moore, LPN
• Claudia Gail Moran, MS OTRL

• Pediatrics Physician in Sherwood, AR
• Providers in Sherwood, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.