Kimberly G Montgomery, PHD HSPP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

20040771A Issued in IN

Practice address

6296 Rucker Rd Ste a
Indianapolis, IN 46220-4852

Phone

(317) 580-4007

Fax

(833) 244-0469

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Kimberly Montgomery PHD HSPP LLC

  • Psychologist
  • Indianapolis, IN
  • NPI 1609530120
  Medicare reassignment NPD Authorized official
• Serdan Group, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1487821856
  NPD (past) Authorized official
• Buckingham and Associates PC

  • Mental Health Counselor
  • Indianapolis, IN
  • NPI 1588617138
  NPD (past)
• Choices Psychology Consultation Center, Inc.

  • Psychologist
  • Indianapolis, IN
  • NPI 1609996388
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635552000000",
    "number": "1821170861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6296 RUCKER RD STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204852",
            "telephone_number": "317-580-4007",
            "fax_number": "833-244-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6296 RUCKER RD STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204852",
            "telephone_number": "317-580-4007",
            "fax_number": "833-244-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KIMBERLY",
        "middle_name": "G",
        "credential": "PHD HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-10-30",
        "certification_date": "2021-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20040771A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Montgomery
• Bethany Jane Montgomery
• Caitlin Jean Montgomery
• Gregory S Montgomery, MD
• Kelsey A Montgomery, DO
• Lashanda Montgomery
• Laura Montgomery, OTR
• Lowayne Montgomery, CCHW, NPP
• Madison Taylor Montgomery, DO
• Meagan Montgomery, LMHC

• Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.