Active NPI
Jessica Montgomery
- Student in an Organized Health Care Education/Training Program
- Austin, TX
National Provider Identifier
1871112128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1301 W 38TH St Ste 705
Austin, TX 78705-1016 - Phone
- (734) 712-3967
- NPI assigned
- Apr 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MI | Primary |
Addresses
Primary practice location
1301 W 38TH St Ste 705
Austin, TX 78705-1016
Mailing address
11298 Maple Valley Dr
Plymouth, MI 48170-6390
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240808000973 | TX | Order and Referring Only - Obstetrics/Gynecology | 2567886302 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719014400000",
"number": "1871112128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11298 MAPLE VALLEY DR",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481706390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 W 38TH ST STE 705",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051016",
"telephone_number": "734-712-3967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-15",
"last_updated": "2024-06-22",
"certification_date": "2024-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.