Individual provider Active NPI

Sarah Montgomery, NP

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1801675376
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71014518A Issued in IN
Practice address
7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone
(317) 621-6262
NPI assigned
Sep 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 71014518A IN Primary

Addresses

Primary practice location

7150 Clearvista Dr
Indianapolis, IN 46256-1695

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231108002455 IN Practitioner - Nurse Practitioner 2466809793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71014518AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Nov 1, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Nov 1, 2023 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Organizations & group practices 2

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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1801675376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 CLEARVISTA DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561695",
            "telephone_number": "317-621-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "SARAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71014518A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.