Montgomery Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3560301N Issued in NY

Legal business name

MONTGOMERY NURSING HOME

Practice address

2817 Albany Post Rd
Montgomery, NY 12549-2132

Phone

(845) 457-3155

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy R Mack

Title

Partner

Phone

(845) 457-3155

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Montgomery Nursing and Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Montgomery Operating Co LLC

  • Skilled Nursing Facility
  • Montgomery, NY
  • NPI 1336478775
  NPD tax ID

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972669364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ALBANY POST RD",
            "city": "MONTGOMERY",
            "state": "NY",
            "postal_code": "125492132",
            "telephone_number": "845-457-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ALBANY POST RD",
            "city": "MONTGOMERY",
            "state": "NY",
            "postal_code": "125492132",
            "telephone_number": "845-457-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "845-457-3155",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "3560301N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00311486",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Modugno, PT DPT
• Phyllis Arlene Montanari, MA, LCAT, MT-BC
• Montefiore Medical Center
• Melanie Ann Montenora
• Montgomery Massage Therapy Group, P.C.
• Montgomery Operating Co LLC
• Montgomery Physical Therapy & Wellness PC (Access Physical Therapy & Wellness)
• Montgomery Village Pharmacy Inc (Montgomery Village Pharmacy)
• Millicent Evadne Morgan, LPN
• Jennifer L Motta-Conklin, OT

• Skilled Nursing Facility in Montgomery, NY
• Providers in Montgomery, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.