JANESSA ANNETTE MONTGOMERY (NPI# 1225679012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225679012 |
| Entity Type | Individual |
| Full Name | JANESSA ANNETTE MONTGOMERY |
| Other Name | JANESSA ANNETTE FREEMAN |
| Credential | DNP |
| Practice Address |
5510 Utica Ridge Rd Davenport IA 52807-2946 |
| Mailing Address |
332 Rock Ridge Rd Nw Cedar Rapids IA 52405-5307 |
| Practice Telephone | 5634242025 |
| Mailing Telephone | 3193894295 |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-10-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
C154761 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | STATE LICENSE | C154761 | 01 |
| Street Address |
5510 UTICA RIDGE RD |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52807-2946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871928093 | Catherine Ann Roche | Nurse Practitioner | 5510 Utica Ridge Rd, Suite 100, Davenport, IA 52807-2946 | 2013-09-06 |
| 1124449780 | Bolger Aesthestics, PC | Clinic/Center | 5510 Utica Ridge Rd, Suite 300, Davenport, IA 52807-2946 | 2013-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710455423 | Sarah Duvall | Pharmacist | 2790 East 53rd Street, Davenport, IA 52807 | 2018-11-12 |
| 1932686375 | Costco Wholesale Corporation | Hearing Aid Equipment | 2790 East 53rd St., Davenport, IA 52807 | 2018-07-27 |
| 1902258379 | Secure Dental II, LLC | Dentist | 5025 Utica Ridge Rd, Suite 103, Davenport, IA 52807 | 2016-07-08 |
| 1003288663 | Kristin Landram | Pharmacist | 4011 E 53rd Street, Davenport, IA 52807 | 2015-10-22 |
| 1912384918 | Toshia Johnson | Counselor | 3515 Spring Street, Davenport, IA 52807 | 2015-04-29 |
| 1366849440 | Dennis Aaron Brown | Counselor | 2322 E. Kimberly Rd., Ste. 200 N., Davenport, IA 52807 | 2014-12-04 |
| 1033514914 | Rachel J Staron | Counselor | 2028 E 38th St Ste 3-5, Davenport, IA 52807 | 2014-11-04 |
| 1447651518 | Anthony B. Dexter | Chiropractor | 2178 E Kimberly Rd Ste 400, Davenport, IA 52807 | 2014-09-09 |
| 1932517588 | Alan Christopher Rubach | Dentist | 3435 Spring St Ste 2, Davenport, IA 52807 | 2014-07-28 |
| 1851707459 | Allison Maxwell | Behavioral Analyst | 4959 Utica Ridge Rd, Davenport, IA 52807 | 2014-07-03 |
| Find all providers in zip 52807 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871928093 | Catherine Ann Roche | Nurse Practitioner | 5510 Utica Ridge Rd, Suite 100, Davenport, IA 52807-2946 | 2013-09-06 |
| 1700398336 | Dana Gant | Nurse Practitioner | 2506 Sand Mine Rd, Davenport, FL 33897-3402 | 2017-11-05 |
| 1679098016 | Shelby Marie Pelzer | Nurse Practitioner | 5510 Utica Ridge Rd Ste 100, Davenport, IA 52807-2935 | 2017-08-07 |
| 1073999868 | Carrie Braet | Nurse Practitioner | 500 W River Dr, Davenport, IA 52801-1014 | 2015-08-04 |
| 1124422985 | Tina Coakley | Nurse Practitioner | 5510 Utica Ridge Rd Ste 100, Davenport, IA 52807-2935 | 2014-10-22 |
| 1275874273 | Amy Marie Mccormick | Nurse Practitioner | 500 W River Dr, Davenport, IA 52801-1014 | 2013-03-15 |
| 1538400718 | Lisa Jo Schilling | Nurse Practitioner | 40124 Highway 27 Ste 207, Davenport, FL 33837-5905 | 2013-03-12 |
| 1205074713 | Melissa Lynn Jobgen | Nurse Practitioner | 5510 Utica Ridge Rd Ste 100, Davenport, IA 52807-2935 | 2009-01-22 |
| 1275529430 | Beverly A Smith | Nurse Practitioner | 500 W River Dr, Davenport, IA 52801-1014 | 2005-09-23 |
| 1255337176 | Brenda L Swanson | Nurse Practitioner | 1351 W Central Park Ave, Ste 4100, Davenport, IA 52804-1847 | 2005-06-24 |
| Find all providers in DAVENPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.