Individual provider Active NPI

Kristian Montgomery

  • Early Intervention Provider Agency
  • Port St. Lucie, FL
National Provider Identifier
1801614854
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Practice address
1193 SE Port St Lucie Blvd PMB 107
Port St. Lucie, FL 34952-5332
Phone
(772) 207-1091
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X FL
Early Intervention Provider Agency 252Y00000X FL Primary

Addresses

Primary practice location

1193 SE Port St Lucie Blvd PMB 107
Port St. Lucie, FL 34952-5332

Mailing address

1193 SE Port St Lucie Blvd
PMB# 107
Port St Lucie, FL 34952-5332
Phone (504) 275-8333

Other practice location 1

3267 SW Constellation Rd
Port St Lucie, FL 34953-4637
Phone (504) 275-8333

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

Practice roles

OrganizationSpecialtyStatusNew patients
K B Family Connections Developmental Therapist PastSince Oct 6, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1801614854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1193 SE PORT ST LUCIE BLVD",
            "address_2": "PMB# 107",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525332",
            "telephone_number": "504-275-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 SE PORT ST LUCIE BLVD PMB 107",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "349525332",
            "telephone_number": "772-207-1091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3267 SW Constellation Rd",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349534637",
            "country_code": "US",
            "telephone_number": "504-275-8333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KRISTIAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St. Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.