DR. CANAAN MATTHEW MONTGOMERY (NPI# 1225442288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225442288 |
| Entity Type | Individual |
| Full Name | DR. CANAAN MATTHEW MONTGOMERY |
| Credential | O.D. |
| Practice Address |
1005 W Vine St Vienna IL 62995-1586 |
| Practice Telephone | 6186582195 |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1958DT | KY | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | 046010816 | IL | Eye and Vision Services Providers |
| Street Address |
1005 W VINE ST |
| City | VIENNA |
| State | IL |
| Zip Code | 62995-1586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538663463 | Gregory M Blakely | Physical Therapist | 811 North 1st Street, Vienna, IL 62995 | 2018-03-23 |
| 1194101196 | Ashley Laws | Counselor | 408 E. Vine, Vienna, IL 62995 | 2015-08-03 |
| 1477981421 | Amanda Endrizzi | Physician Assistant | 803 North 1st Street, Vienna, IL 62995 | 2013-10-29 |
| 1780831453 | Family Counseling Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 904 Vine Street, Vienna, IL 62995 | 2008-08-25 |
| 1528215290 | Family Counseling Center, Inc. | Clinic/Center | 406 East Vine Street, Vienna, IL 62995 | 2008-08-25 |
| 1770676207 | Martha Jane Crawford | Social Worker | 408 E Vine, Vienna, IL 62995 | 2006-10-02 |
| 1235147216 | Rachel Ann Edmonds | Physical Therapist | 811 N 1st Street, Vienna, IL 62995 | 2006-08-04 |
| 1376572552 | Bode Drug Inc | Pharmacy | 803 and One Half N First St, Vienna, IL 62995 | 2006-07-01 |
| 1578557476 | Roger Franklin High | Chiropractor | 122 N 4th St, Vienna, IL 62995 | 2005-09-07 |
| 1932263332 | Rural Health, Inc. | Clinic/Center | 803 N 1st St, Vienna, IL 62995 | 2006-12-20 |
| Find all providers in zip 62995 | ||||
| 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 |
|---|---|---|---|---|
| 1518433796 | Kelci Walters | Optometrist | 1950 Old Gallows Rd Ste 520, Vienna, VA 22182-3970 | 2018-10-16 |
| 1669914412 | Visual Health Doctors of Optometry | Optometrist | 1927c Old Gallows Rd, Vienna, VA 22182-3924 | 2016-11-10 |
| 1871963488 | Associates In Eyecare-merrifield | Optometrist | 2672 Avenir Pl, Suite L, Vienna, VA 22180-7193 | 2015-09-25 |
| 1831504976 | Ansu Mariam Nathan | Optometrist | 8369 Leesburg Pike Ste A, Vienna, VA 22182-2421 | 2014-06-27 |
| 1538468764 | Family Eyedoctors Pllc | Optometrist | 1500 Grand Central Ave Ste 112, Vienna, WV 26105-1079 | 2011-03-28 |
| 1669503256 | Eyes On Grand Central Inc | Optometrist | 2653 Grand Central Ave, Vienna, WV 26105-1334 | 2007-03-08 |
| 1164566147 | Suleiman S Alibhai | Optometrist | 2227 Woodford Rd, Vienna, VA 22182-5084 | 2007-02-16 |
| 1083756746 | The Lasik Vision Institue, LLC | Optometrist | 8614 Westwood Center Dr, Suite 650, Vienna, VA 22182-2233 | 2007-02-12 |
| 1689729451 | Armin Namazizadeh | Optometrist | 2110 Gallows Rd # C, Suite 2, Vienna, VA 22182-3962 | 2007-01-24 |
| 1548325558 | Vienna Optometry, LLC | Optometrist | 401 Maple Ave W, Vienna, VA 22180-4222 | 2006-12-27 |
| Find all providers in VIENNA | ||||
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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.