Rena D Montgomery, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN14046 Issued in TN

Practice address

125 Guthrie Dr
Southaven, MS 38671-5829

Phone

(901) 252-3400

Fax

(901) 763-4305

NPI assigned

May 26, 2009

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)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rena.montgomery.p1@direct.cpc.nextgenshare.com

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.

• Conrad Pearson Clinic

  • Medical Specialty Clinic/Center
  • Germantown, TN
  • NPI 1174864946
  NPD (past)
• Mid-South Ear, Nose, and Throat, P.C.

  • Otolaryngology Physician
  • Germantown, TN
  • NPI 1689780066
  NPD (past)
• North Internal Medicine, P. C.

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1518982008
  NPD (past)

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1871728436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR",
            "address_2": "STE 103",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381759",
            "telephone_number": "901-252-3400",
            "fax_number": "901-763-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 GUTHRIE DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715829",
            "telephone_number": "901-252-3400",
            "fax_number": "901-763-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "RENA",
        "middle_name": "D",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-26",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN14046",
            "primary": true
        },
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "TN",
            "license": "APN14046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Mitchell, M.ED., NCC
• Terry L Mix, DPH
• Modern Vascular of Southaven, LLC
• Pamela Michelle Molck, CPNP-PC
• Penelope Montgomery
• Lacey Moody
• Moore Speech Therapy, LLC
• Anna Moore
• Apryl Suzanne Moore, SLP
• Jennifer E Moore, MS, RDN, LDN, CSR

• Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.