Active NPI
John Michael Montgomery, MD
- Family Medicine Physician
- Jacksonville, FL
National Provider Identifier
1851591853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME72630
- Practice address
- 4800 Deerwood Campus Pkwy
Building 600 1St Floor
Jacksonville, FL 32246 - Phone
- (904) 905-8419
- Fax
- (904) 357-8372
- NPI assigned
- Jul 19, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME72630 | FL | Primary |
Addresses
Primary practice location
4800 Deerwood Campus Pkwy
Building 600 1St Floor
Jacksonville, FL 32246
Mailing address
4800 Deerwood Campus Pkwy
Building 600 1St Floor
Jacksonville, FL 32246
Phone (904) 905-8419
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME72630 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians Group Services PA | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Orange Park, FL
- NPI 1861440810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1851591853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 DEERWOOD CAMPUS PKWY",
"address_2": "BUILDING 600 1ST FLOOR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32246",
"telephone_number": "904-905-8419",
"fax_number": "904-357-8372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 DEERWOOD CAMPUS PKWY",
"address_2": "BUILDING 600 1ST FLOOR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32246",
"telephone_number": "904-905-8419",
"fax_number": "904-357-8372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-19",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME72630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.