Active NPI
Aaron Tyler Montgomery, CDCA
- Case Manager/Care Coordinator
- Ironton, OH
National Provider Identifier
1730688136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- CDCA.165856
- Practice address
- 700 Park Ave
Ironton, OH 45638-1502 - Phone
- (740) 532-1613
- Fax
- (740) 532-1715
- NPI assigned
- Feb 12, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CDCA.165856 | OH | Primary |
Addresses
Primary practice location
700 Park Ave
Ironton, OH 45638-1502
Mailing address
PO Box 108
Ironton, OH 45638-0108
Phone (740) 532-1613
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0275642 | Medicaid | OH |
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 |
|---|---|---|---|
| CDCA.165856 | OH | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536537600000",
"number": "1730688136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 108",
"city": "IRONTON",
"state": "OH",
"postal_code": "456380108",
"telephone_number": "740-532-1613",
"fax_number": "740-532-1715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 PARK AVE",
"city": "IRONTON",
"state": "OH",
"postal_code": "456381502",
"telephone_number": "740-532-1613",
"fax_number": "740-532-1715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "AARON",
"middle_name": "TYLER",
"credential": "CDCA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-12",
"last_updated": "2018-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OH",
"license": "CDCA.165856",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0275642",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ironton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.