MR. TRAVIS H MONTGOMERY (NPI# 1316210040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316210040 |
| Entity Type | Individual |
| Full Name | MR. TRAVIS H MONTGOMERY |
| Credential | PA-C |
| Practice Address |
222 Medical Cir Morehead KY 40351-1179 |
| Practice Telephone | 6067836520 |
| Practice Fax Number | 6067836489 |
| Mailing Telephone | 6067836520 |
| Mailing Fax Number | 6067836489 |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2019-03-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA1714 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1714 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100216070 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154323731 | Travis J Montgomery | Podiatrist | 3731 Guion Road, Suite C, Indianapolis, IN 46222-7604 | 2005-08-12 |
| 1679054696 | Travis Montgomery | Specialist/Technologist, Other | 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 | 2018-08-27 |
| Street Address |
222 MEDICAL CIR |
| City | MOREHEAD |
| State | KY |
| Zip Code | 40351-1179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679573471 | William D Lewis | Radiology | 222 Medical Cir, Morehead, KY 40351-1179 | 2005-07-22 |
| 1215541149 | Elizabeth Deeley | Dietitian, Registered | 222 Medical Cir, Morehead, KY 40351-1179 | 2020-09-08 |
| 1669092474 | Gregory James Hall | Pharmacist | 222 Medical Cir, Morehead, KY 40351-1179 | 2020-04-22 |
| 1497383400 | Alyssa Gail Elswick | Student in an Organized Health Care Education/Training Program | 222 Medical Cir, Morehead, KY 40351-1179 | 2020-03-27 |
| 1083241079 | Makayla Lewis | Student in an Organized Health Care Education/Training Program | 222 Medical Cir, Morehead, KY 40351-1179 | 2020-03-27 |
| 1891322079 | Jenna Renee Bartley | Student in an Organized Health Care Education/Training Program | 222 Medical Cir, Morehead, KY 40351-1179 | 2020-03-26 |
| 1720615123 | Derek Allan Keller | Student in an Organized Health Care Education/Training Program | 222 Medical Cir, Morehead, KY 40351-1179 | 2020-03-25 |
| 1235764358 | Jesse Mehring | Physical Therapist | 222 Medical Cir, Morehead, KY 40351-1179 | 2020-03-09 |
| 1598397036 | Danielle L Owens | Nurse Practitioner | 222 Medical Cir, Morehead, KY 40351-1179 | 2020-02-12 |
| 1477190064 | Brentney M Fields | Pharmacist | 222 Medical Cir, Morehead, KY 40351-1179 | 2019-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881267 | Ready Lab LLC | Clinical Medical Laboratory | 2575 Ky Hwy 801 North, Suite B, Morehead, KY 40351 | 2020-11-02 |
| 1235765082 | Debbie Lynn Hudson | Behavior Technician | The Kidspot Center, 12008 W Us 60, Olive Hill, KY 40351 | 2020-03-12 |
| 1578020210 | The Family Healing Center, Inc | Clinic/Center | 241 East Main Street, Morehead, KY 40351 | 2019-03-01 |
| 1407312184 | Kyle Charles Wolff | Specialist/Technologist | 111 Playforth Place, Morehead, KY 40351 | 2019-02-18 |
| 1184195992 | Alyssa Davis | Emergency Medicine | 111 Academic-athletic Center, Morehead, KY 40351 | 2018-12-06 |
| 1891262325 | Garla Kathleen Hart | Social Worker | 500 Hecks Plaza, Morehead, KY 40351 | 2018-11-02 |
| 1508365230 | Alyson Ewigman | Specialist/Technologist | 195 Academic-athletic Center, Morehead, KY 40351 | 2018-02-08 |
| 1417490764 | Jordan Kelley | Specialist/Technologist | 195 Academic Athletic Center, Morehead, KY 40351 | 2016-11-18 |
| 1275903924 | Terri Dickerson | Counselor | 505 Hecks Plaza, Morehead, KY 40351 | 2015-10-06 |
| 1013313162 | Mt Sterling Pediatrics | Family Medicine | 130 New Towne Square, Morehead, KY 40351 | 2014-11-17 |
| Find all providers in zip 40351 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881755494 | Jerry L Newman | Physician Assistant | 234 Medical Circle, Morehead, KY 40351-1181 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497364335 | Ryan Williamson | Physician Assistant | 1149 Delaney Ferry Rd, Nicholasville, KY 40356-8727 | 2020-07-27 |
| 1811518541 | Autumn Rose Ballard | Physician Assistant | 141 Mallard Dr, Frankfort, KY 40601-8647 | 2020-05-05 |
| 1558982348 | Damian Morriston | Physician Assistant | 7088 Aspen Grove Ct, Louisville, KY 40241-2522 | 2020-05-03 |
| 1063041457 | Molly Ritter | Physician Assistant | 2310 Woodbourne Ave Apt 13, Louisville, KY 40205-1752 | 2020-04-07 |
| 1710525944 | Aaron Dewayne Petrey | Physician Assistant | 475 N Highway 25 W Ste 100, Williamsburg, KY 40769-1576 | 2019-12-18 |
| 1437704921 | Daniel Lee Mullins | Physician Assistant | 122 Travis Way, Georgetown, KY 40324-0500 | 2019-08-02 |
| 1871150649 | East Ky Health Service Center | Physician Assistant | 566 Highway 899 # 849, Hindman, KY 41822-8955 | 2019-05-28 |
| 1629533310 | Michelle Ladanyi | Physician Assistant | 1140 Lexington Rd Ste 102, Georgetown, KY 40324-9330 | 2019-02-06 |
| 1629582739 | Addie C Rosenberger | Physician Assistant | 200 E Chestnut St Bldg Ste 303, Louisville, KY 40202-1831 | 2017-11-28 |
| 1255788725 | Affinity Health Care Psc | Physician Assistant | 22055 Main St, Hyden, KY 41749-8568 | 2016-05-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. TRAVIS H MONTGOMERY.
| 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.