KYLE BRADEN MONTGOMERY (NPI# 1548775281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548775281 |
| Entity Type | Individual |
| Full Name | KYLE BRADEN MONTGOMERY |
| Credential | PA-C |
| Practice Address |
1 Cooper Plz Camden NJ 08103-1461 |
| Mailing Address |
1 Federal St # 200 Camden NJ 08103-1088 |
| Practice Telephone | 8563422000 |
| Mailing Telephone | 8563564924 |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2020-06-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 25MP00465200 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1769 Hillside Dr, Cherry Hill, NJ 080033707 | 7033507597 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053732776 | Kyle Adrian Montgomery | Specialist/Technologist | 2761 Sea Pines Cir E, Clearwater, FL 33761-3008 | 2013-12-23 |
| 1679559223 | Kyle David Montgomery | Family Medicine | 2317 E Westmoreland St, Phila, PA 19134-4529 | 2005-12-15 |
| 1831546399 | Kyle Vincent Montgomery | Pharmacist | 675 Folly Rd, Charleston, SC 29412-3000 | 2016-05-15 |
| Street Address |
1 COOPER PLZ |
| City | CAMDEN |
| State | NJ |
| Zip Code | 08103-1461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230911 | Daniel Kwa | Acupuncturist | 1 Cooper Plz, Camden, NJ 08103-1461 | 2005-07-26 |
| 1053910927 | Shane Aldon Cooper | Nurse Practitioner | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-10-22 |
| 1396351722 | Christopher Alexander Rivera-pintado | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-09-21 |
| 1285252361 | Dhaval Dharmendra Rana | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-06 |
| 1891312195 | Vincent Verchio | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-02 |
| 1861019036 | Calvin Ro | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-02 |
| 1770100943 | Andrea Villa | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-02 |
| 1376160739 | Kristen Knapp | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-01 |
| 1447874417 | Cassie Seto | Nurse Anesthetist, Certified Registered | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-06-04 |
| 1215551437 | Cooper Care Alliance, PC | Specialist | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516063 | Toni Marie Primas | Registered Nurse | Sheridan Pavilion, Three Cooper Plaza Suite 220, Camden, NJ 08103 | 2020-07-24 |
| 1376028548 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 805-815 Federal Street, Camden, NJ 08103 | 2018-10-03 |
| 1942795802 | Kyle Richard Marden | Student in an Organized Health Care Education/Training Program | 401 Haddon Avenue, 2nd Floor Room 266, Camden, NJ 08103 | 2018-06-24 |
| 1588157473 | Julio Antonio Rodriguez Jr. | Student in an Organized Health Care Education/Training Program | Cooper University Hospital, 3 Cooper Plaza Suite 408, Camden, NJ 08103 | 2018-06-14 |
| 1386149748 | Shuchi Gupta | Nurse Practitioner | 519 West Street, Camden, NJ 08103 | 2018-03-28 |
| 1326541491 | Bolanle Idowu-akangbe | Nurse Practitioner | 519-525 West Street, Camden, NJ 08103 | 2018-03-14 |
| 1740709500 | New Beginnings Behavioral Health | Clinic/Center | 1300 Princess Avenue, Camden, NJ 08103 | 2017-09-13 |
| 1760905012 | Loraine Morris | Counselor | 1479 Kaighn Ave, Camden, NJ 08103 | 2017-07-19 |
| 1386164333 | Matthew Share | Genetic Counselor, MS | Two Cooper Plaza, 400 Haddon Avenue, Md Anderson Cancer Center, Camden, NJ 08103 | 2017-06-21 |
| 1568902070 | Cooper University Hospital | General Acute Care Hospital | 1 Cooper Plaza, Dorrance 222, Camden, NJ 08103 | 2017-03-02 |
| Find all providers in zip 08103 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245634989 | Rebecca Ann Kenderes | Physician Assistant | 5 Masonic Avenue, Camden, NY 13316 | 2014-10-09 |
| 1033402599 | Colonial Family Practice, LLC | Physician Assistant | 1124 Little St, Camden, SC 29020-3613 | 2011-05-17 |
| 1023124161 | Michael Joe Ridley | Physician Assistant | 306 Highway 641 N, Camden, TN 38320-3012 | 2006-08-22 |
| 1073580452 | Jessica C Bethell Barsocchi | Physician Assistant | 3 Cooper Plz Rm 311, Camden, NJ 08103 | 2006-03-03 |
| 1699382440 | David Allen Davidson | Physician Assistant | 353 Cash Rd Sw, Camden, AR 71701-3704 | 2020-09-25 |
| 1346876331 | Amelia Anna Porretta | Physician Assistant | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-03-21 |
| 1285260828 | Paola Genevieve Suriel | Physician Assistant | 3 Cooper Plz Rm 215, Camden, NJ 08103-1438 | 2020-03-16 |
| 1417583253 | Alyssa Palio | Physician Assistant | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-03-12 |
| 1003442831 | Patrick Keenan | Physician Assistant | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-03-12 |
| 1457991903 | Idan Waksman | Physician Assistant | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2020-01-13 |
| Find all providers in CAMDEN | ||||
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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.