Jeffrey Montgomery, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008990 Issued in IL

Practice address

162 THF Blvd
Chesterfield, MO 63005-1141

Phone

(636) 537-0700

Fax

(636) 536-2066

NPI assigned

May 6, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prairie Eye Center, LTD

  • Optometrist
  • Lincoln, IL
  • NPI 1366035644
  NPD

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1760431019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "618-462-9818",
            "fax_number": "800-432-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 THF BLVD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051141",
            "telephone_number": "636-537-0700",
            "fax_number": "636-536-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00218689",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Momba Home Care Missouri, LLC
• Monarch Fire Protection District
• Taylor Christine Monken Malach, MABA, BCBA, LBA
• Charles A. Montani Jr., RPH
• Alice Elizabeth Montgomery, SPEECH PATHOLOGIST,
• Patrick Montgomery, D.C.
• Bayli Mooney, DPT
• Jamie Moore
• Laura Irene Moore, M.D.
• Andrea Lynn Morgan, APRN, FNP-C

• Optometrist in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.