Individual provider Active NPI

Heather Collins Montgomery, FNP

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1629203310
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14126 Issued in TN
Practice address
4501 Amnicola Hwy
Chattanooga, TN 37406-1018
Phone
(423) 697-5521
Fax
(423) 697-4707
NPI assigned
May 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 14126 TN Primary

Addresses

Primary practice location

4501 Amnicola Hwy
Chattanooga, TN 37406-1018

Mailing address

4501 Amnicola Highway
Student Center Ste 133
Chattanooga, TN 37406-1782
Phone (423) 697-5521

Other identifiers 3

IdentifierTypeStateIssuer
130529501FMedicaidGA
1517467MedicaidTN
2009001637OtherANCC CERTIFICATION

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
I20090730000503 TN Practitioner - Nurse Practitioner 0749333227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga State Community College Student Health Clinic CurrentSince Feb 23, 2025 Accepting new patients
Southeastern Emergency Services of Memphis, P.C. Past Accepting new patients

Locations

4501 Amnicola Hwy
Ste 133
Chattanooga, TN 37406
Phone (423) 697-5522

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1243209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1629203310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 AMNICOLA HIGHWAY",
            "address_2": "STUDENT CENTER STE 133",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374061782",
            "telephone_number": "423-697-5521",
            "fax_number": "423-697-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 AMNICOLA HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374061018",
            "telephone_number": "423-697-5521",
            "fax_number": "423-697-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "HEATHER",
        "middle_name": "COLLINS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-25",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "14126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130529501F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517467",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC CERTIFICATION",
            "identifier": "2009001637",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.