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NPI Code Detail

MEDICARE: TRICIA DAWN MONTGOMERY R.D., CDE

MEDICARE: TRICIA DAWN MONTGOMERY R.D., CDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian925937AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00624820OTHERAZRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144203712
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRICIA DAWN MONTGOMERY R.D., CDE
Provider Business Mailing Address
First Line : PO BOX 17808
Second Line :
City : TUCSON
State : AZ
Zip : 85731-7808
Country : US
Telephone Number : 623-256-8380
Fax Number :
Provider Business Practice Location Address
First Line : 13400 E SHEA BLVD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259-5499
Country : US
Telephone Number : 480-301-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2005
Last Update Date : 11/22/2022

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