Individual provider Active NPI

Chloe B. Montgomery

  • Social Worker
  • Mansfield, OH
National Provider Identifier
1609333103
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1903804 Issued in OH
Practice address
1451 Lucas Rd
Mansfield, OH 44903-8682
Phone
(419) 589-5511
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1903804 OH Primary

Addresses

Primary practice location

1451 Lucas Rd
Mansfield, OH 44903-8682

Mailing address

1451 Lucas Rd
Mansfield, OH 44903-8682
Phone (419) 589-5511

Other practice location 1

270 Sterkel Blvd
Mansfield, OH 44907-1508
Phone (419) 756-1133

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
S.1903804OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1609333103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 LUCAS RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449038682",
            "telephone_number": "419-589-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 LUCAS RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449038682",
            "telephone_number": "419-589-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Sterkel Blvd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449071508",
            "country_code": "US",
            "telephone_number": "419-756-1133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "CHLOE",
        "middle_name": "B.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1903804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.