Justin A Montgomery, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

17660 Issued in TN

Practice address

378 Marketplace Dr
Suite 5
Johnson City, TN 37604-2361

Phone

(423) 282-0751

Fax

(423) 282-1577

NPI assigned

Jun 3, 2013

Last updated

Jun 25, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellmont Medical Associates Inc

  dba Ballad Health Medical Associates

  • Pulmonary Disease Physician
  • Bristol, TN
  • NPI 1780986257

  Nurse Practitioner

  Medicare reassignment NPD
• Las Cruces Physician Practices, LLC

  dba NM Cardiovascualr Associates

  • Vascular Surgery Physician
  • Las Cruces, NM
  • NPI 1093947491
  Medicare reassignment NPD
• Southwest Emergency Medical Associates of NM PC

  • Emergency Medicine Physician
  • Las Cruces, NM
  • NPI 1720505571

  Nurse Practitioner

  Medicare reassignment NPD
• Wellmont Medical Associates, Inc.

  dba Ballad Health Medical Associates

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• Las Cruces Physician Practices, LLC

  dba New Mexico Cardiac Care

  • Cardiovascular Disease Physician
  • Las Cruces, NM
  • NPI 1346586195
  NPD
• Las Cruces Physician Practices, LLC

  dba General Surgery Associates

  • Surgery Physician
  • Las Cruces, NM
  • NPI 1376866947
  NPD
• Wellmont Medical Associates, Inc.

  dba Ballad Health Medical Associates

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1154789030
  NPD (past)
• Harbor Blvd Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Port Charlotte, FL
  • NPI 1700138997
  NPD (past)

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1770920621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 MARKETPLACE DR",
            "address_2": "SUITE 5",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042361",
            "telephone_number": "423-282-0751",
            "fax_number": "423-282-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JUSTIN",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17660",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Mona, OD
• Rachel Monderer, MD
• Jessica Danielle Moniz-Ocasio
• Franklin Montenegro, MD
• Ashlee Montgomery, FNP
• Stephen Patrick Montgomery, MD
• Amy Herron Moody, DDS
• Paul Tyler Moody, DPT
• Samuel Moody
• Summer L Moody, FNP-C

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.