Fred Adams Montgomery, MD

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

MD00009512 Issued in WA

Practice address

215 S 11TH Ave
D
Yakima, WA 98902-3255

Phone

(509) 248-6192

Fax

(509) 452-5433

NPI assigned

May 13, 2008

Last updated

May 13, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1780851261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S 11TH AVE",
            "address_2": "D",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023255",
            "telephone_number": "509-248-6192",
            "fax_number": "509-452-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S 11TH AVE",
            "address_2": "D",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023255",
            "telephone_number": "509-248-6192",
            "fax_number": "509-452-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "FRED",
        "middle_name": "ADAMS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "WA",
            "license": "MD00009512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Albert Monick, MD
• Rachel Elizabeth Monick, M.D.
• Shayla R Moniz, MC
• Barbara Monjaraz
• Marisela J Montelongo
• Megan Montour
• Alex Moon, P.T.
• David Andrew Moon, OD
• Jill Moon, DPT
• Andrea Moore

• Addiction Psychiatry Physician in Yakima, WA
• Providers in Yakima, WA by specialty
• Addiction Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.