Kathleen Jo Montgomery, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

COA.10766-NP Issued in OH

Practice address

3620 Court Drive
Zanesville, OH 43701

Phone

(740) 454-1248

Fax

(740) 454-8183

NPI assigned

Aug 20, 2009

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 identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Coler Hospice, LTD

  • Community Based Hospice Care Agency
  • Zanesville, OH
  • NPI 1225580665
  NPD (past)
• Perry County Family Practice, Inc.

  • Primary Care Clinic/Center
  • New Lexington, OH
  • NPI 1003088790
  NPD (past)
• Perry County Family Practice, Inc.

  • Rural Health Clinic/Center
  • New Lexington, OH
  • NPI 1174792014
  NPD (past)

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306108800000",
    "number": "1629200902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 1821",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437021821",
            "telephone_number": "740-455-3304",
            "fax_number": "740-455-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 COURT DRIVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "43701",
            "telephone_number": "740-454-1248",
            "fax_number": "740-454-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KATHLEEN",
        "middle_name": "JO",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2011-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN241205",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.10766-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3026988",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019285",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00914840",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mobile Optometry, LLC
• Jignesh Jashawant Modi, MD
• Nassar Mohammad, DDS
• Tami L Mohan, PA-C
• Dalisa Renee Monlux, LPN
• Robert E Montgomery, LPCC
• Emily Moor, COTA/L
• Jennifer L Moore
• Jerry W Moore, MD
• Joshua Moore, D.O.

• Nurse Practitioner in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2011; 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.