NPI Code Detail JSON Logo

1295021210 NPI number — STEPHANIE LEANN MONTGOMERY O.D

NPI Number: 1295021210
Health Care Provider/Practitioner: STEPHANIE LEANN MONTGOMERY O.D

Information about “1295021210” NPI (STEPHANIE LEANN MONTGOMERY O.D) exists in 1295021210 in HTML format HTML  |  1295021210 in plain Text format TXT  |  1295021210 in PDF (Portable Document Format) PDF  |  1295021210 in an XML format XML  formats.

NPI Number : 1295021210 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295021210",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MONTGOMERY",
    "FirstName": "STEPHANIE",
    "MiddleName": "LEANN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "O.D",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BAKER",
    "OtherFirstName": "STEPHANIE",
    "OtherMiddleName": "LEANN",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "O.D",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "21311 S MEADOWS DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRHOPE",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "36532-4474",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "423-580-1247",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "101 FLY CREEK AVE STE 307",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRHOPE",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "36532-8310",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "251-383-2052",
    "PracticeLocationAddressFaxNumber": "251-383-2062",
    "EnumerationDate": "06/28/2011",
    "LastUpdateDate": "05/02/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "S-C52-TA-891",
        "LicenseNumberStateCode": "AL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.