Active NPI
Mia Bianca Montgomery, P.T.
- Physical Therapist
- Hyattsville, MD
National Provider Identifier
1669626586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT870925
- Practice address
- 3920 Livingston St
Hyattsville, MD 20781-1739 - Phone
- (313) 286-7142
- NPI assigned
- Nov 5, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT870925 | DC | Primary |
Addresses
Primary practice location
3920 Livingston St
Hyattsville, MD 20781-1739
Mailing address
3920 Livingston St
Hyattsville, MD 20781-1739
Phone (313) 286-7142
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT870925 | DC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587772800000",
"number": "1669626586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3920 LIVINGSTON ST",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207811739",
"telephone_number": "313-286-7142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3920 LIVINGSTON ST",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207811739",
"telephone_number": "313-286-7142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "MIA",
"middle_name": "BIANCA",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-05",
"last_updated": "2020-04-25",
"certification_date": "2020-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "PT870925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyattsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.