Mackenzie Blair Montag, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN.1632920 Issued in CO

Practice address

10465 Park Meadows Dr Ste 201
Lone Tree, CO 80124-5321

Phone

(303) 790-1515

Fax

(303) 790-1989

NPI assigned

Apr 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mackenzie Blair Patterson Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mackenzie.montag@hca3.eclinicaldirectplus.com

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.

• Healthone Clinic Services - Pediatric Specialties LLC

  • Pediatrics Physician
  • Denver, CO
  • NPI 1720293251
  NPD
• Healthone Clinic Services - Pediatric Specialties LLC

  • Pediatric Gastroenterology Physician
  • Lone Tree, CO
  • NPI 1063237766
  NPD (past)

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1609439371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10465 PARK MEADOWS DR STE 201",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245321",
            "telephone_number": "303-790-1515",
            "fax_number": "303-790-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10465 PARK MEADOWS DR STE 201",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245321",
            "telephone_number": "303-790-1515",
            "fax_number": "303-790-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAG",
        "first_name": "MACKENZIE",
        "middle_name": "BLAIR",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "RN.1632920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "PATTERSON",
            "middle_name": "BLAIR",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Mohr
• Barry L Molk, M.D.
• Sarah Monchak, RN
• Ella-Maisha Moncur, APN, FNP-BC
• Michael James Monnet, LPC
• Sonia Mookherjea
• Jeffrey Saba Moon, PHARM.D
• Ashley Lambert Moore, RN
• Christopher C Moore, C-APN
• Jason Robert Moore, PA-C

• Pediatric Nurse Practitioner in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Pediatric Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.