DR. MICHAEL R MONTGOMERY (NPI# 1124002969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124002969 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL R MONTGOMERY |
| Credential | OD |
| Practice Address |
279 E Elm St Lebanon MO 65536-3610 |
| Practice Telephone | 4175322562 |
| Practice Fax Number | 4175322409 |
| Mailing Telephone | 4175322562 |
| Mailing Fax Number | 4175322409 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2012-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | T02552 | MO | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 117105 | 01 | |
| MO | 312368319 | 05 | |
| SPECTERA-LEBANON LOCATION | 12603 | 01 | |
| BCBC-LEBABON LOCATION | 117102 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184018814 | Michael Montgomery | Specialist/Technologist | 621 Southgate Rd, Carroll, IA 51401-3277 | 2015-03-19 |
| 1063660041 | Michael O'neill Montgomery | Internal Medicine | 249 Forrest Rd, Yardley, PA 19067-3322 | 2008-09-03 |
| 1700965134 | Michael Todd Montgomery | Dentist | 7551 Callaghan Rd, #210, San Antonio, TX 78229-2860 | 2006-11-05 |
| 1477633196 | Michael Clinton Montgomery | Dentist | 1040 Barclay Dr, Madison, GA 30650-4621 | 2006-10-17 |
| 1366553166 | Michael T Montgomery | Family Medicine | 469 Emily Dr, Clarksburg, WV 26301-5512 | 2006-08-31 |
| 1396858759 | Michael Montgomery | Pharmacist | 930 S. Main St, Nicholasville, KY 40356-2152 | 2006-08-17 |
| 1689643116 | Michael Wayne Montgomery | Specialist/Technologist | 102 Crystal Springs Dr, Bardstown, KY 40004-8203 | 2006-03-16 |
| 1235126533 | Michael Christopher Montgomery | Dentist | 8055 W Manchester Ave, Suite 500, Playa Del Rey, CA 90293-7960 | 2005-10-02 |
| 1053780007 | Michael Albert Montgomery | Registered Nurse | 319 E Water St, Syracuse, NY 13202-1123 | 2015-09-21 |
| 1699110361 | Michael Boone Montgomery | Student in an Organized Health Care Education/Training Program | 800 Lakeshore Dr, Birmingham, AL 35229-0001 | 2013-05-07 |
| Street Address |
279 E ELM ST |
| City | LEBANON |
| State | MO |
| Zip Code | 65536-3610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427537307 | Cathy Jane Greenlee | Nurse Practitioner | 510 Hwy 32, Lebanon, MO 65536 | 2018-08-10 |
| 1396232831 | Steven Michael Majdecki | Counselor | 860 Lynn St., Lebanon, MO 65536 | 2018-04-19 |
| 1447629399 | Danielle Craig | Speech-Language Pathologist | 1200 Clark Ave, Lebanon, MO 65536 | 2015-09-22 |
| 1982080255 | Dawn Barker | Family Medicine | 331 Hospital Dr Ste C, Lebanon, MO 65536 | 2015-08-10 |
| 1194163840 | Laura Patton | Speech-Language Pathologist | 22864 Perimeter Drive, Lebanon, MO 65536 | 2013-06-04 |
| 1750588273 | Elaine Britzman | Registered Nurse | 874 S Jefferson St, Lebanon, MO 65536 | 2007-06-28 |
| 1538363486 | Laclede Co. Assoc. for Retarded Citizens | Respite Care | 200 Lawson Ave., Lebanon, MO 65536 | 2007-06-13 |
| 1568665768 | Fern M Klein | Registered Nurse | 874 S Jefferson, Lebanon, MO 65536 | 2007-06-06 |
| 1639201080 | Laclede County Assoc. for Retarded Citizens | Day Training, Developmentally Disabled Services | 200 Lawson Avenue, Lebanon, MO 65536 | 2007-03-12 |
| 1316078868 | Michael Montgomery Od PC | Optometrist | 279 E Elm, Lebanon, MO 65536 | 2007-03-08 |
| Find all providers in zip 65536 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639731250 | Caitlin Squires | Optometrist | 90 Market St Ste 20, Lebanon, OR 97355-2396 | 2019-07-03 |
| 1083100424 | Myeyedr Optometry of Indiana, LLC | Optometrist | 2705 N Lebanon St Ste 230, Lebanon, IN 46052-8627 | 2018-07-09 |
| 1184118747 | Brian Swoyer | Optometrist | 758 Cumberland St, Lebanon, PA 17042-5247 | 2018-06-18 |
| 1841727286 | Tyler Ross Boone | Optometrist | 404 N Castle Heights Ave Ste A, Lebanon, TN 37087-1512 | 2017-05-16 |
| 1104255942 | Eyecare Indiana | Optometrist | 1202 N Lebanon St, Lebanon, IN 46052-1510 | 2013-11-02 |
| 1407160120 | Mascoma Eyecare | Optometrist | 24 Hanover Street, Suite 3a, Lebanon, NH 03766-1334 | 2010-08-05 |
| 1063654838 | Independence Corporation | Optometrist | 905 E Cumberland St, Lebanon, PA 17042-8102 | 2009-03-25 |
| 1316078868 | Michael Montgomery Od PC | Optometrist | 279 E Elm, Lebanon, MO 65536 | 2007-03-08 |
| 1659407989 | Melissa Sue Kerby | Optometrist | 1001 Monroe Rd, Lebanon, OH 45036-1414 | 2007-02-23 |
| 1144378480 | William Grant IIi | Optometrist | 19595 Houston Rd, Lebanon, MO 65536-8252 | 2007-01-05 |
| Find all providers in LEBANON | ||||
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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.