Healthcare Provider Details

I. General information

NPI: 1497620942
Provider Name (Legal Business Name): MEREDITH SHARPE MONTGOMERY WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 SUNSET BLVD STE 201
WEST COLUMBIA SC
29169-4837
US

IV. Provider business mailing address

PO BOX 6069
WEST COLUMBIA SC
29171-6069
US

V. Phone/Fax

Practice location:
  • Phone: 803-254-1300
  • Fax: 803-771-7597
Mailing address:
  • Phone: 803-254-1300
  • Fax: 803-771-7597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number31148
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: