ROBERTA J MONTGOMERY CNP NPI 1508837774

NPI Information

NPI: 1508837774
Provider Name: ROBERTA J MONTGOMERY, CNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1527 BROADWAY ST
ALEXANDRIA, MN
ZIP 56308
Phone: (320) 762-0399
Get Directions

Roberta J Montgomery, CNP is a family nurse practitioner in Alexandria, MN. Roberta J Montgomery, CNP NPI is 1508837774. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1527 BROADWAY ST
ALEXANDRIA, MN
ZIP 56308-537
Phone: (320) 762-0399
Fax: (320) 762-6847

The NPI 1508837774 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/27/2006 and was last updated on 2/10/2014.

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	363LF0000X	Nurse Practitioner	Family	R1401381	MINNESOTA	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	A020	OTHER	MINNESOTA	CHAMPUS
2	1022855	OTHER	MINNESOTA	PREFERRED ONE
3	857963	OTHER	MINNESOTA	AMERICA'S PPO
4	731528700	MEDICAID	MINNESOTA
5	HP34223	OTHER	MINNESOTA	HEALTH PARTNERS
6	S98100	MEDICARE UPIN	MINNESOTA
7	500001836	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA
8	0107835	OTHER	MINNESOTA	MEDICA
9	140897D277	OTHER	MINNESOTA	UCARE
10	51G60MO	OTHER	MINNESOTA	BLUE SHIELD

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: 5/5/2024

NPI Synchronization or Removal

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