MR. TOM MONTGOMERY NPI 1205225117

NPI Information

NPI: 1205225117
Provider Name: MR. TOM MONTGOMERY
Classification: Nursing Home Administrator - 376G00000X
Entity Type: Individual
Address:
1929 BETTY JANE LN
MUSKOGEE, OK
ZIP 74403
Phone: (918) 683-9407
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MR. Tom Montgomery is a nursing home administrator in Muskogee, OK. The provider is an individual, often licensed by the state, who is responsible for the management of a nursing home. MR. Tom Montgomery NPI is 1205225117. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1929 BETTY JANE LN
MUSKOGEE, OK
ZIP 74403-581
Phone: (918) 683-9407

The enumeration date for this NPI number is 1/15/2015 and was last updated on 1/15/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	376G00000X	Nursing Home Administrator		2286	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200106120A	MEDICAID	OKLAHOMA
2	375174	OTHER	OKLAHOMA	MEDICARE PROVIDER ENROLLMENT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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