Active NPI
Susan Montgomery, OTR
- Occupational Therapist
- Morgantown, WV
National Provider Identifier
1679641567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 938
- Practice address
- 1 Medical Center Drive
Morgantown, WV 26505 - Phone
- (304) 598-4118
- NPI assigned
- Dec 1, 2006
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 938 | WV | Primary |
Addresses
Primary practice location
1 Medical Center Drive
Morgantown, WV 26505
Mailing address
725 Madison Ave
Morgantown, WV 26501-6721
Phone (304) 296-5881
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810003992 | Medicaid | WV |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 938 | WV | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679641567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 MADISON AVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265016721",
"telephone_number": "304-296-5881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DRIVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "26505",
"telephone_number": "304-598-4118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "SUSAN",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WV",
"license": "938",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810003992",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.