Ryan L Montgomery

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

29483 Issued in TX

Practice address

3012 Green Meadow Drive
San Angelo, TX 76904-2262

Phone

(502) 777-9016

NPI assigned

Mar 22, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ryan L Montgomery DDS MD PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • San Angelo, TX
  • NPI 1477925873
  NPD (past) Authorized official

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

{
    "created_epoch": "1237680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1679714604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5122 BEVERLY DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76904",
            "telephone_number": "502-777-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 GREEN MEADOW DRIVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769042262",
            "telephone_number": "502-777-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "RYAN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-22",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "29483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Maya Montes, LVN
• Mary A Montez, CHW/CHWI
• Clifton J Montgomery, DDS
• Melinda M. Montgomery, M.S., L.P.C., L.P.A.
• Rachel Montgomery, RBT
• Tony Montgomery, DMD
• William Atterbury Montgomery, PH.D.
• Steve Frank Montoya Jr., M.D.
• Alexis Jade Moon
• Alexis Moore, PMHNP-BC

• Oral & Maxillofacial Surgery (D.M.D.) in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.