Stephen Montgomery, MD
Individual provider Active NPI Family Medicine Physician · Pontotoc, MS
NPI 1699735159 · NPPES record last updated Feb 21, 2011
Key facts
- NPI
- 1699735159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 10719 (MS)
- Practice address
- 345 Highway 15 N
Pontotoc, MS 38863-1105 - Phone
- (662) 489-7430
- Fax
- (662) 489-7938
- NPI assigned
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 9
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Mississippi School of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pontotoc Health Services, Inc.
Tri-Vista Rehab, Inc.
Practice addresses (Care Compare)
345 Hwy 15 N
Pontotoc Medical
Pontotoc, MS 38863-3311
Phone (662) 489-7430
90 Clark Ave a
Tupelo, MS 38804-2801
Hospital & facility affiliations
- North Mississippi Medical Ctr HHA
- Baptist Home Care and Hospice North Mississippi
- Centerwell Home Health
- Pontotoc Health Service Inc Cah
- North Mississippi Medical Center
- Baptist Memorial Hospital Union County
- BMH-Calhoun
- Sunshine Health Care, Inc
- Pontotoc Health & Rehab Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Sunshine Health Care, Inc |
Skilled nursing facility | Adp of the SNF | Jul 1, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090217000419 | MS | Practitioner - Family Practice | 4486719978 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Mississippi Medical Center | Current | Accepting new patients | |
| Pontotoc Health Services, Inc. | Current | Accepting new patients | |
| Pontotoc Health Services, Inc. | Current |
Accepting new patients | |
| Pontotoc Health Services, Inc. | Current |
Accepting new patients | |
| Pontotoc LTC, Inc | Past | Accepting new patients | |
| Sunshine Health Care, Inc | Past | Accepting new patients | |
| Pontotoc Health Services, Inc. | Past | Accepting new patients |
Locations
202 Main St
Ecru, MS 38841
Phone (662) 489-4345
400 Doctors Dr
New Albany, MS 38652
Phone (662) 534-5036
345 Highway 15 N
Pontotoc, MS 38863
Phone (662) 489-7430
176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510
Interoperability endpoints
- stevemontgomery@nmhs.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10719 | MS | Yes |
Addresses
Primary practice location
345 Highway 15 N
Pontotoc, MS 38863-1105
Mailing address
345 Highway 15 N
Pontotoc, MS 38863-1105
Phone (662) 489-7430
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00114314 | Medicaid | MS |
Other providers in Pontotoc, MS
- Mississippi CVS Pharmacy, L.L.C.
- Mississippi Professional Counseling Associates
- Mississippi State Department of Health
- Montgomery Drug Co Inc
- Brandy Montgomery
- Christa Waldrop Moore
- Regan Watson Moore
- Elizabeth L Murrah
- Santanna Nesbitt
- North Mississippi Foot Specialists PC
All providers in Pontotoc, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.