Travis Montgomery, RNFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

238000654 Issued in IL

Practice address

4400 W 95TH St Ste 308
Oak Lawn, IL 60453-2660

Phone

(708) 346-4040

Fax

(708) 346-3287

NPI assigned

Aug 27, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1679054696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 BORMET DR STE 204",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488399",
            "telephone_number": "708-346-4044",
            "fax_number": "708-346-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 308",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532660",
            "telephone_number": "708-346-4040",
            "fax_number": "708-346-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "TRAVIS",
        "name_prefix": "Mr.",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "IL",
            "license": "041472495",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "238000654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL RN LICENSE",
            "identifier": "041472495",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL SA LICENSE",
            "identifier": "238000654",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret V Montejano
• Marcus Montes
• Brianne Montesdeoca
• Malika Montgomery
• Paul Montgomery, MD
• Beatriz Montoya
• Sheri Moonan, CNS, APN
• Amy M Moore
• Cierra Moore
• Griffin Moore, DO

• Surgical Assistant in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Surgical Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.

Verify at the official NPI Registry.