Individual provider Active NPI

Jason Montegna, PHARMD

  • Pharmacist
  • Kennesaw, GA
National Provider Identifier
1639430424
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH025612 Issued in GA
Practice address
225 Townpark Dr NW
Suite 300
Kennesaw, GA 30144-5886
Phone
(678) 581-4408
NPI assigned
Jun 7, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH025612 GA Primary

Addresses

Primary practice location

225 Townpark Dr NW
Suite 300
Kennesaw, GA 30144-5886

Mailing address

225 Townpark Dr NW
Suite 300
Kennesaw, GA 30144-5886
Phone (678) 581-4408

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH025612GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1639430424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 TOWNPARK DR NW",
            "address_2": "SUITE 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445886",
            "telephone_number": "678-581-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 TOWNPARK DR NW",
            "address_2": "SUITE 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445886",
            "telephone_number": "678-581-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEGNA",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH025612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.