Individual provider Active NPI

Megan Leigh Montgomery-Nibbe, DC

  • Chiropractor
  • Poplar Bluff, MO
National Provider Identifier
1831612209
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2017024842 Issued in MO
Practice address
1907 N Westwood Blvd
Poplar Bluff, MO 63901-2807
Phone
(573) 772-5451
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2017024842 MO Primary

Addresses

Primary practice location

1907 N Westwood Blvd
Poplar Bluff, MO 63901-2807

Mailing address

1907 N Westwood Blvd
Poplar Bluff, MO 63901-2807
Phone (573) 772-5451

Other names 1

  • Dr. Megan Leigh Montgomery Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016002924 MO Practitioner - Chiropractic 4587930722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017024842MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Day One Chiropractic LLC Chiropractor CurrentSince Nov 2, 2021 Accepting new patients
Visiting Nurse Association of Southeast Missouri Inc PastSince Mar 25, 2022 Accepting new patients
Black River Healthcare, Inc. PastSince Sep 10, 2017 Accepting new patients

Locations

1907 N Westwood Blvd
Poplar Bluff, MO 63901
Phone (573) 686-3480

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1831612209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012807",
            "telephone_number": "573-772-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012807",
            "telephone_number": "573-772-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY-NIBBE",
        "first_name": "MEGAN",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017024842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "MONTGOMERY",
            "middle_name": "LEIGH",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.