Individual provider Active NPI

Jon M Montgomery, DO

  • Student in an Organized Health Care Education/Training Program
  • Camp Pendleton, CA
National Provider Identifier
1770764953
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Naval Hospital, Camp Pendleton
H100 Santa Margarita Road/ Attention: Code 094
Camp Pendleton, CA 92055-5191
Phone
(760) 725-1394
NPI assigned
Nov 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Naval Hospital, Camp Pendleton
H100 Santa Margarita Road/ Attention: Code 094
Camp Pendleton, CA 92055-5191

Mailing address

Naval Hospital, Camp Pendleton
H100 Santa Margarita Road/ Attention: Code 094
Camp Pendleton, CA 92055-5191

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
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1770764953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL, CAMP PENDLETON",
            "address_2": "H100 SANTA MARGARITA ROAD/ ATTENTION: CODE 094",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL, CAMP PENDLETON",
            "address_2": "H100 SANTA MARGARITA ROAD/ ATTENTION: CODE 094",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-725-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JON",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.