Active NPI
Paula Jean Montgomery, PHYSICIAN ASSOCIATE
- Physician Assistant
- Oklahoma City, OK
National Provider Identifier
1952382590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA175
- Practice address
- 4140 W Memorial Rd
Plaza 308
Oklahoma City, OK 73120-8366 - Phone
- (405) 749-7031
- Fax
- (405) 749-7036
- NPI assigned
- Nov 10, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA175 | OK | Primary |
Addresses
Primary practice location
4140 W Memorial Rd
Plaza 308
Oklahoma City, OK 73120-8366
Mailing address
4140 W Memorial Rd
Plaza 308
Oklahoma City, OK 73120-8366
Phone (405) 749-7031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA175 | OK | MD | Physician Assistant |
Interoperability endpoints
- pmontgomery@direct.uspi.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185148800000",
"number": "1952382590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 W MEMORIAL RD",
"address_2": "PLAZA 308",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731208366",
"telephone_number": "405-749-7031",
"fax_number": "405-749-7036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4140 W MEMORIAL RD",
"address_2": "PLAZA 308",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731208366",
"telephone_number": "405-749-7031",
"fax_number": "405-749-7036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "PAULA",
"middle_name": "JEAN",
"credential": "PHYSICIAN ASSOCIATE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-10",
"last_updated": "2007-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "PA175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.