Active NPI
Kyle Vincent Montgomery, PHARM. D.
- Pharmacist
- Mount Pleasant, SC
National Provider Identifier
1831546399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36521
- Practice address
- 2195 Tea Planter LN
Mount Pleasant, SC 29466-7804 - Phone
- (843) 881-2622
- NPI assigned
- May 15, 2016
- Last updated
- Mar 31, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36521 | SC | Primary |
Addresses
Primary practice location
2195 Tea Planter LN
Mount Pleasant, SC 29466-7804
Mailing address
2170 Snyder Cir Apt 315
Mount Pleasant, SC 29466-7819
Phone (843) 637-6092
Other practice location 1
675 Folly Rd
Charleston, SC 29412-3000
Phone (843) 406-7085
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36521 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Teeter, LLC | Past | Accepting new patients | |
| Harris Teeter LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Mount Pleasant, SC
- NPI 1144544883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1831546399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2170 SNYDER CIR APT 315",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294667819",
"telephone_number": "843-637-6092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2195 TEA PLANTER LN",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294667804",
"telephone_number": "843-881-2622"
}
],
"practiceLocations": [
{
"address_1": "675 Folly Rd",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294123000",
"country_code": "US",
"telephone_number": "843-406-7085",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "KYLE",
"middle_name": "VINCENT",
"name_prefix": "Dr.",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-15",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "36521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.