Elisabeth Montague, MD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

34107 Issued in NC

Practice address

218 Old Mocksville Rd
Anesthesia Dept
Statesville, NC 28625-1930

Phone

(704) 873-0281

NPI assigned

Jan 23, 2006

Last updated

Aug 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Hospice of Iredell County, Inc

  • Community Based Hospice Care Agency
  • Statesville, NC
  • NPI 1336243997
  NPD (past)
• Tko Anesthesia PA

  • Anesthesiology Physician
  • Statesville, NC
  • NPI 1720068935
  NPD (past)

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1811967011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 651711",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282651711",
            "telephone_number": "704-873-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 OLD MOCKSVILLE RD",
            "address_2": "ANESTHESIA DEPT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251930",
            "telephone_number": "704-873-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "34107",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": "34107",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "NC",
            "license": "34107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8960069",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kthomas@healing-transitions.org",
            "affiliation": "N",
            "endpointDescription": "clinical coordinator business email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1251 Goode St",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276032261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Monarch (UMAR-Weaver)
• Kera Cosper Mondez, DNP, FNP-C
• Patricia Williamson Monroe, P.T.
• Sarah Renee Montgomery, M.ED.
• Tara Moon, M.D.
• Ashley Elizabeth Moore, FNP
• Erin Rochelle Moore, IBCLC, CD-DONA
• Janiyah Renee Moore, LCSWA

• Addiction Medicine (Preventive Medicine) Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Addiction Medicine (Preventive Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.