Individual provider Active NPI

Mariah Kay Montague, DC, MS

  • Chiropractor
  • Fishers, IN
National Provider Identifier
1831852557
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003259A Issued in IN
Practice address
8924 E 96TH St
Fishers, IN 46037-9648
Phone
(317) 588-9414
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003259A IN Primary

Addresses

Primary practice location

8924 E 96TH St
Fishers, IN 46037-9648

Mailing address

4108 Elkhorn Dr
Westfield, IN 46062-6528
Phone (217) 521-9138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001000176 IN Practitioner - Chiropractic 5991236002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2021
Medicare assignment
May accept Medicare assignment
Group practices
The Kingdom Chiropractic LLCGroup PAC ID 4082145198, 2 clinicians

Practice addresses (Care Compare)

8924 E 96TH St
Fishers, IN 46037-9648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
The Kingdom Chiropractic LLC Chiropractor CurrentSince Aug 24, 2024 Accepting new patients
Premier Sports Chiropractic of Indiana , P.C. Chiropractor PastSince Oct 1, 2021 Accepting new patients

Locations

8924 E 96th St
Fishers, IN 46037
Phone (317) 578-4100

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": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1831852557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 ELKHORN DR",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460626528",
            "telephone_number": "217-521-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8924 E 96TH ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379648",
            "telephone_number": "317-588-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "MARIAH",
        "middle_name": "KAY",
        "credential": "DC, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003259A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.