Active NPI
Rebecca Piles Montgomery, MD
- Family Medicine Physician
- Davidson, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9600646
- Practice address
- 104 Knox CT Ste 100
Davidson, NC 28036-0590 - Phone
- (704) 892-5454
- Fax
- (704) 892-5858
- NPI assigned
- Sep 20, 2005
- Last updated
- Dec 20, 2022
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9600646 | NC | Primary |
Addresses
Primary practice location
104 Knox CT Ste 100
Davidson, NC 28036-0590
Mailing address
PO Box 4329
Davidson, NC 28036-4329
Phone (704) 892-5454
Other practice location 1
150 Fairview Rd Ste 210
Mooresville, NC 28117-9507
Phone (704) 235-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891010L | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Kentucky College of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
104 Knox CT
Suite 100
Davidson, NC 28036-0590
Phone (704) 892-5454
7510 Ramble Way
Suite 107
Raleigh, NC 27616-4305
Phone (919) 747-3033
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9600646 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avance Care, PA | Current | Accepting new patients | |
| Afc Urgent Care and Family Care of WNC, PLLC | Current | Accepting new patients | |
| Advanced Healthcare | Family Medicine | Past | Accepting new patients |
Locations
10102 Johnston Rd
Charlotte, NC 28210
Phone (704) 247-6578
14001 E Independence Blvd
Ste C
Indian Trail, NC 28079
Phone (704) 247-6598
7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880
1025 Peerless Xing NW
Cleveland, TN 37312
Phone 4234765990 ext. 104
Interoperability endpoints
- rebecca.montgomery.1@29681.direct.athenahealth.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Fuquay Varina, NC
- NPI 1487845020
-
dba Afc Urgent Care
- Urgent Care Clinic/Center
- Charlotte, NC
- NPI 1679066658
-
- Family Medicine Physician
- Mooresville, NC
- NPI 1124084702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1760478358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4329",
"city": "DAVIDSON",
"state": "NC",
"postal_code": "280364329",
"telephone_number": "704-892-5454",
"fax_number": "704-892-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 KNOX CT STE 100",
"city": "DAVIDSON",
"state": "NC",
"postal_code": "280360590",
"telephone_number": "704-892-5454",
"fax_number": "704-892-5858"
}
],
"practiceLocations": [
{
"address_1": "150 Fairview Rd Ste 210",
"address_purpose": "LOCATION",
"city": "Mooresville",
"state": "NC",
"postal_code": "281179507",
"country_code": "US",
"telephone_number": "704-235-0300",
"fax_number": "704-235-1803",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "REBECCA",
"middle_name": "PILES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-20",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "9600646",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891010L",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Davidson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.