DR. C. TED MONTGOMERY (NPI# 1093717159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093717159 |
| Entity Type | Individual |
| Full Name | DR. C. TED MONTGOMERY |
| Credential | M.D. |
| Practice Address |
3550 University Blvd S Ste 301 Jacksonville FL 32216-4225 |
| Mailing Address |
915 W Monroe St Ste 200 Jacksonville FL 32204-1177 |
| Practice Telephone | 9043842240 |
| Practice Fax Number | 9044480030 |
| Mailing Telephone | 9043842240 |
| Mailing Fax Number | 9044480030 |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2009-11-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ME10755 | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 371200100 | 05 |
| Street Address |
3550 UNIVERSITY BLVD S STE 301 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-4225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154736304 | Johnny Jada Md | Pediatrics | 3550 University Blvd S, Ste 206, Jacksonville, FL 32216-4246 | 2014-06-26 |
| 1316282478 | Florida Physician Specialists LLC | Urology | 3550 University Blvd S, Suite 202, Jacksonville, FL 32216-4246 | 2012-11-30 |
| 1316194780 | Mellissa Settles | Nurse Practitioner | 3550 University Blvd S, Suite 206, Jacksonville, FL 32216-4246 | 2008-08-27 |
| 1396917910 | Northeast Florida Endocrine and Diabetes Associates Pa | Durable Medical Equipment & Medical Supplies | 3550 University Blvd S, Ste 204, Jacksonville, FL 32216-4246 | 2008-03-25 |
| 1871702928 | Ne Fl Endocrine & Diabetes Assoc, Pa | Specialist | 3550 University Blvd S, Jacksonville, FL 32216-4246 | 2007-05-22 |
| 1013922749 | Edward S Pereira | Internal Medicine | 3550 University Blvd S, Suite 302, Jacksonville, FL 32216-4246 | 2006-07-30 |
| 1831124510 | Ira Michael Jackler | Internal Medicine | 3550 University Blvd S, Suite 207, Jacksonville, FL 32216-4246 | 2006-07-11 |
| 1336170422 | Critical Care of N Jacksonville, Pa | Internal Medicine | 3550 University Blvd S, Suite 207, Jacksonville, FL 32216-4246 | 2006-07-06 |
| 1154396984 | Salwa S Ayad | Specialist | 3550 University Blvd S, Ste 301, Jacksonville, FL 32216-4246 | 2006-02-23 |
| 1295706364 | Robert Miller | Internal Medicine | 3550 University Blvd S, Suite 204, Jacksonville, FL 32216-4255 | 2006-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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|---|---|---|---|---|
| 1437768033 | Coastal Injury Clinic LLC | Specialist | 2700 Riverside Ave Ste 1, Jacksonville, FL 32205-8233 | 2020-07-29 |
| 1255957643 | Rhonda D Smith Roberts | Specialist | 2754 Sam Hardwick Blvd, Jacksonville, FL 32246-3892 | 2020-06-22 |
| 1437620986 | Nicole Azaan | Specialist | 2301 Indian Dr Apt 29c, Jacksonville, NC 28546-5258 | 2018-12-10 |
| 1598251910 | Allionz LLC | Specialist | 2386 Dunn Ave Ste 109, Jacksonville, FL 32218-4751 | 2018-07-09 |
| 1093236531 | Leah F Friedman | Specialist | 1650 Prudential Dr Ste 102, Jacksonville, FL 32207-8148 | 2017-07-06 |
| 1609301993 | Oakleaf Injury and Pain Center LLC | Specialist | 9526 Argyle Forest Blvd, B-6, Jacksonville, FL 32222-2825 | 2017-04-25 |
| 1982070140 | Riverside Spine & Pain Physicians, LLC | Specialist | 13133 Professional Dr, Suite 200, Jacksonville, FL 32225-7122 | 2015-08-11 |
| 1235525239 | Elizabeth Wehr | Specialist | 319 1st Ave N Apt 1a, Jacksonville, FL 32250-5500 | 2015-04-07 |
| 1053705236 | Orthowilmington, Pa | Specialist | 3382 Henderson Dr, Jacksonville, NC 28546-5230 | 2015-03-25 |
| 1295156941 | Southeast Orthopedic Specialists, Inc. | Specialist | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2013-12-26 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
Please comment or provide details below to improve the information on DR. C. TED 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.