RENA D MONTGOMERY (NPI# 1871728436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871728436 |
| Entity Type | Individual |
| Full Name | RENA D MONTGOMERY |
| Credential | APN |
| Practice Address |
125 Guthrie Dr Southaven MS 38671-5829 |
| Mailing Address |
1325 Wolf Park Dr Ste 103 Germantown TN 38138-1759 |
| Practice Telephone | 9012523400 |
| Practice Fax Number | 9017634305 |
| Mailing Telephone | 9012523400 |
| Mailing Fax Number | 9017634305 |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2017-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | APN14046 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SW0102X |
Clinical Nurse Specialist Specialization: Women's Health |
APN14046 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
125 GUTHRIE DR |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-5829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323461 | Lauren Elizabeth Boone | Nurse Practitioner | 3415 Shiloh Ln, Southaven, MS 38672-6045 | 2020-07-21 |
| 1558979229 | Adrianne Amanda Anderson | Nurse Practitioner | 8390 Ansley Park Ln, Southaven, MS 38672-8340 | 2020-07-20 |
| 1033765730 | Angela Oigbokie | Nurse Practitioner | 5833 Strawberry Pointe Cv, Southaven, MS 38672-6619 | 2019-08-18 |
| 1598124927 | Harmony Health, Pllc | Nurse Practitioner | 4744 We Ross Pkwy, Southaven, MS 38671-7169 | 2016-02-12 |
| 1891103313 | Connie Jean Hodge | Nurse Practitioner | 5699 Getwell Rd Ste 3, Southaven, MS 38672-7312 | 2014-07-28 |
| 1669955423 | Tannisha Monique Loggins | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-09-07 |
| 1528558061 | Deera Warren | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671 | 2018-05-10 |
| 1871083386 | Kenneth A Krzyzkowski | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-05-10 |
| 1700383007 | Aaron Douglas Smith | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671 | 2018-04-12 |
| 1235653445 | Catherine Ruth Smith | Nurse Practitioner | 7362 Southcrest Pkwy, Southaven, MS 38671 | 2017-07-29 |
| Find all providers in SOUTHAVEN | ||||
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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.