Patricia Lee Montgomery, PA-C
Individual provider Active NPI Physician Assistant · Bayboro, NC
NPI 1871609693 · NPPES record last updated Jun 1, 2018
Key facts
- NPI
- 1871609693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-06097 (NC)
- Practice address
- 606 Main St
Bayboro, NC 28515 - Phone
- (252) 745-3191
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085-001309 | IL | MD | Physician Assistant |
| 0010-06097 | NC | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085-001309 | IL | |
| Physician Assistant | 363A00000X | 0010-06097 | NC | Yes |
Addresses
Primary practice location
606 Main St
Bayboro, NC 28515
Mailing address
1005 Health Center Drive
Suite 103
Mattoon, IL 61938
Phone (217) 258-4051
Other names
- Patricia Lee Rardin
Other providers in Bayboro, NC
- Alexandria Leigh Kirian
- Cindy Oldson Lamielle
- Suman Lamsal
- Sue Hollowell Lee
- Colin F Mann
- Charlene McClure Morris
- George H Nashick
- Pamlico County Department of Social Services
- Pamlico County Rescue Squad Inc
- Pamlico County Schools
All providers in Bayboro, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.