Bethany A Montgomery

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.005335 Issued in IL

Practice address

805 E Gregory Ave
Marion, IL 62959-3325

Phone

(618) 922-8898

NPI assigned

Feb 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1861959520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E GREGORY AVE",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593325",
            "telephone_number": "618-922-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E GREGORY AVE",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593325",
            "telephone_number": "618-922-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "BETHANY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.005335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadasivam Modali, M.D
• Miteshkumar N Modi, PA-C
• Shawna Mohler, DT
• Clinton Jay Mohr, M.D.
• Shannon Mohr, RPH
• Sidney Renae Moore
• Jacob Morgan, PHARM.D.
• Melissa Ann Morley, DMD
• Abby Morris
• Heather Lynn Morris, OTR/L

• Physical Therapy Assistant in Marion, IL
• Providers in Marion, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.