LACRISTA MONTGOMERY (NPI# 1710505649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710505649 |
| Entity Type | Individual |
| Full Name | LACRISTA MONTGOMERY |
| Credential | SPECIALUST |
| Practice Address |
811 Garfield St Tupelo MS 38801-5748 |
| Mailing Address |
142 Woodgreen Rd Apt 23 Plantersville MS 38862-9709 |
| Practice Telephone | 6624226044 |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
0059659 | MS | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | SPECIALIST | 0059659 | 01 |
| Street Address |
811 GARFIELD ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-5748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114134863 | Karen Ashmore Maltby | Allergy & Immunology | 811 Garfield St, Tupelo, MS 38801-5748 | 2007-05-16 |
| 1699930339 | North Mississippi Allergy and Asthma Center Pllc | Allergy & Immunology | 811 Garfield St, Tupelo, MS 38801-5748 | 2008-07-22 |
| 1679784599 | Matthew Lee Oswalt | Allergy & Immunology | 811 Garfield St, Tupelo, MS 38801-5748 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023653714 | Aundray Terall Shackelford | Specialist | 105 Rankin Blvd Ext, Tupelo, MS 38801-4611 | 2019-11-17 |
| 1194383398 | Candice Williams | Specialist | 820 N Gloster St, Tupelo, MS 38804-1949 | 2019-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715216 | Stacy Michelle Reed | Specialist | 121 Lonnie Jenkins Dr, Pearl, MS 39208-3520 | 2020-09-22 |
| 1962014100 | Orthotic & Prosthetic Solutions LLC | Specialist | 3670 Lakeland Ln # B-4, Jackson, MS 39216-4700 | 2020-08-19 |
| 1598252645 | Catiecha L Edwards | Specialist | 1162 Franklin St, Grenada, MS 38901-4237 | 2018-04-14 |
| 1992200950 | Cristy M Mathews | Specialist | 132 Paulding Rd, Leakesville, MS 39451-3073 | 2018-03-29 |
| 1386146520 | Jan A Jordan | Specialist | 1615 2nd Ave N, Columbus, MS 39701-4927 | 2018-03-04 |
| 1679085948 | Alan Evans | Specialist | 106 North Lafayette St, Starkville, MS 39759 | 2017-10-26 |
| 1649725409 | Tynita Steele | Specialist | 5304 Gautier Vancleave Rd, Gautier, MS 39553-4216 | 2016-08-22 |
| 1285097048 | The Lauren Forte Hair Loss Replacement Center | Specialist | 143 Laura Lake Rd, Vicksburg, MS 39180-9787 | 2016-03-30 |
| 1073975066 | Dermaine Antwan Johnson | Specialist | 3500 Highway 39 N Apt 77, Meridian, MS 39301-1339 | 2016-03-28 |
| 1710356936 | Sophia Mcquarter | Specialist | 2706 Old Brandon Rd, Pearl, MS 39208-4701 | 2015-09-17 |
| Find all providers with the same taxonomy | ||||
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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.