Tamara Montgomery, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP043753 Issued in AZ

Practice address

13549 N Sanders Rd
Marana, AZ 85653-9505

Phone

(520) 682-1095

Fax

(520) 682-4132

NPI assigned

Jul 1, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Marana Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Marana, AZ
  • NPI 1447263405
  NPD (past)

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1932410248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4560",
            "fax_number": "520-682-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13549 N SANDERS RD",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856539505",
            "telephone_number": "520-682-1095",
            "fax_number": "520-682-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "TAMARA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP043753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindful Recovery Clinic LLC
• Kellie Denise Mitchell, COTA/L
• Karen Lynn Modrzejewski, PMHNP-BC
• Maria Mercedes Molina-Whillock, MS.SLP
• Adolben Y Montesclaros, M.D.
• Timothy Moore, LPC
• Pamela Moorehead, LISAC
• Amy Morris-Ehlo, MS,LPC
• Jossy Najela Mossle, BA, BSN, DNP, PMHNP
• Anna M Motola, DNP, APRN

• Licensed Practical Nurse in Marana, AZ
• Providers in Marana, AZ by specialty
• Licensed Practical Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.