Charles A Montgomery, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13954 Issued in TN

Practice address

109 E Church St
Greeneville, TN 37745-5603

Phone

(423) 638-4131

Fax

(423) 638-9239

NPI assigned

Nov 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holston Medical Group PC

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1831110667
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952477077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E CHURCH ST",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455603",
            "telephone_number": "423-638-4131",
            "fax_number": "423-638-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E CHURCH ST",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455603",
            "telephone_number": "423-638-4131",
            "fax_number": "423-638-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "13954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000039",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BLUECARE",
            "identifier": "43425",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Mitchel, OTR/L
• MLM Drug LLC (Baileyton Drug Company)
• Robert Michael Monahan, PHARMD
• Monarch LTC Inc. (Corley's Pharmacy Solutions)
• Mark C Montemarano, CRT
• Rebecca Miles Moore, BA
• James Brandon Moreland, P.T.
• Ashton Leigh Morelock
• Brooks Morelock, M.D.
• Maxi Douthat Morelock, M.A., CCC-SLP

• Family Medicine Physician in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.