STACEY LEIGH MONTGOMERY ARNP NPI 1104244763

NPI Information

NPI: 1104244763
Provider Name: STACEY LEIGH MONTGOMERY, ARNP
Classification: Nurse Practitioner - 363LA2200X
Specialization: Adult Health
Entity Type: Individual
PECOS Registration: Yes
Address: 890 W FARIS RD STE 580
GREENVILLE, SC
ZIP 29605
Phone: (864) 455-7874

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NPI Details

Stacey Leigh Montgomery, ARNP is an adult health nurse practitioner in Greenville, SC with 12 years of experience. Stacey Leigh Montgomery, ARNP NPI is 1104244763. 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:

890 W FARIS RD STE 580
GREENVILLE, SC
ZIP 29605-281
Phone: (864) 455-7874
Fax: (864) 455-8933

The NPI 1104244763 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Critical care, first 30-74 minutes (HCPCS:99291)
Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)

The enumeration date for this NPI number is 4/1/2014 and was last updated on 6/7/2023.

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	363LC0200X	Nurse Practitioner	Critical Care Medicine	ARNP9235897	FLORIDA	No
2	363LA2200X	Nurse Practitioner	Adult Health	26821	SOUTH CAROLINA	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	PENDING	MEDICAID	SOUTH CAROLINA
2	ARNP9235897	OTHER	FLORIDA	ADVANCED REGISTERED NURSE PRACTITIONER

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: 11/21/2025

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