Keri H Montgomery, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71005783A Issued in IN

Practice address

3900 Washington Ave
Ste 100
Evansville, IN 47714-0550

Phone

(812) 485-6694

Fax

(812) 485-7678

NPI assigned

Sep 17, 2014

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 1

Medicare fee-for-service enrollment

Enrolled in IN

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

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.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585

  Nurse Practitioner

  Medicare reassignment NPD
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310

  Nurse Practitioner

  NPD
• Deaconess Clinic, Inc

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1205082583

  Nurse Practitioner

  NPD
• Deaconess Clinic, Inc

  • Rural Health Clinic/Center
  • Petersburg, IN
  • NPI 1831345792

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1649672056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 WASHINGTON AVE # 100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WASHINGTON AVE",
            "address_2": "STE 100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140550",
            "telephone_number": "812-485-6694",
            "fax_number": "812-485-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KERI",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005783A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71005783A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201324670",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle R. Monroe, LMHC
• Remy Montejano, LMHC
• Montgomery Chiropractic Wellness Center, LLC
• Ashley Elizabeth Montgomery, PHARMD
• Ashlyn Montgomery
• Rick Montgomery, D.C.
• Moon Bay Anesthesia, PC
• McKenzie Lovise Mooney
• Jennifer Moore-Thomas, RD
• Andrew Charles Moore, O.D.

• Pediatric Nurse Practitioner in Evansville, IN
• Providers in Evansville, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.