DR. MONTGOMERY C PEDEN (NPI# 1851349179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851349179 |
| Entity Type | Individual |
| Full Name | DR. MONTGOMERY C PEDEN |
| Credential | MD |
| Practice Address |
101 Professional Lane Enterprise AL 36330 |
| Practice Telephone | 3343473404 |
| Practice Fax Number | 3346930613 |
| Mailing Telephone | 3343473404 |
| Mailing Fax Number | 3343930613 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2016-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 00011984 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 000028378 | 05 | |
| AL | BLUE CROSS BLUE SHIELD | 51028378 | 01 |
| Street Address |
101 PROFESSIONAL LANE |
| City | ENTERPRISE |
| State | AL |
| Zip Code | 36330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083664155 | Rodd Daniel Whitaker | Pediatrics | 101 Professional Lane, Enterprise, AL 36330 | 2006-05-11 |
| 1578512083 | Rick Alan Harrelson | Emergency Medicine | 101 Professional Lane, Enterprise, AL 36330 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566860 | Julia Brooke Lowe | Pharmacist | 847 Boll Weivell Circle #112, Enterprise, AL 36330 | 2020-07-30 |
| 1134759640 | Benjamin Chase Marler | Student in an Organized Health Care Education/Training Program | 205 Somerset Pl, Enterprise, AL 36330 | 2020-01-23 |
| 1033694492 | Angel Melton | Counselor | 105 Searcy St, Enterprise, AL 36330 | 2018-10-01 |
| 1285180729 | Enterprise Urgent Care | Clinic/Center | 6582 Boll Weevil Circle, Enterprise, AL 36330 | 2016-08-25 |
| 1902204258 | Nikki Chen | Nurse Practitioner | 805 East Lee Street, Ste C, Enterprise, AL 36330 | 2014-12-17 |
| 1568795417 | Crystal Juanita Christian | Counselor | 1275 James Drive, Suite A Enterprise Behavioral Services, Enterprise, AL 36330 | 2009-09-10 |
| 1316173206 | Robert Noback | Preventive Medicine | 301 Dustoff Ave, Ft. Rucker, AL 36330 | 2009-06-05 |
| 1184892978 | Phillip Allen Fuller | Pulmonary Function Technologist | 130e.pondella Dr., Enterprise, AL 36330 | 2008-02-14 |
| 1720266778 | Richard Bauer | Emergency Medical Technician, Intermediate | Bld 301 Andrews Ave., Lyster Army Health Clinic, Ft Rucker, AL 36330 | 2008-02-01 |
| 1871646547 | Thomas Orson Patterson | Dentist | 306 South Edwards Street, Enterprise, AL 36330 | 2007-01-18 |
| Find all providers in zip 36330 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750671665 | Anderson Physician Alliance, Inc. | Family Medicine | 83 Old Mill Creek Road, Enterprise, MS 39330-9649 | 2011-04-12 |
| 1528266392 | Lawrence Leonard Woods | Family Medicine | 107 Sw 1st St, Suite 104, Enterprise, OR 97828-1201 | 2007-07-03 |
| 1134130131 | David Nathaniel Arthur Ryan | Family Medicine | 1008 Boll Weevil Cir, Suite B, Enterprise, AL 36330-1312 | 2006-08-11 |
| 1083632244 | Mark Brian Ellis | Family Medicine | 1018 Rucker Blvd, Ste A, Enterprise, AL 36330-3675 | 2006-07-17 |
| 1134162092 | Lawrence Leonard Woods | Family Medicine | 107 Sw 1st St Ste 104, Enterprise, OR 97828-1285 | 2006-06-14 |
| 1124067632 | Walter J Lawrence | Family Medicine | 551 Glover Ave, Enterprise, AL 36330-2041 | 2006-06-06 |
| 1609821263 | Emily A Sheahan | Family Medicine | 616 W North St, Enterprise, OR 97828-1427 | 2006-05-23 |
| 1972575777 | Shean Eric Phelps | Family Medicine | 2 Cottage Ave, Enterprise, AL 36330-8552 | 2006-02-06 |
| 1710967500 | Howard Russell Cook | Family Medicine | 805 E Lee St, Ste C, Enterprise, AL 36330-2477 | 2006-01-18 |
| 1518426493 | Winding Waters Medical Clinic | Family Medicine | 758 Nw 1st St, Enterprise, OR 97828-1527 | 2019-03-19 |
| Find all providers in ENTERPRISE | ||||
| City | ENTERPRISE |
| Zip Code | 36330 |
Please comment or provide details below to improve the information on DR. MONTGOMERY C PEDEN.
| 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.