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KEVIN MONTGOMERY PA-C
NPI 1073023636
Physician Assistant - Medical in Atlanta, GA

Active since October 09, 2017PECOS Enrolled
2174 N DRUID HILLS RD NE, ATLANTA, GA 30329(404) 785-5437 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 3, 2025, Mar 3, 2025, Oct 15, 2021 and 2 more (5 updates tracked since 2017).

About Kevin Montgomery Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN MONTGOMERY PA-C (NPI 1073023636) is an individual medical provider in Atlanta, Georgia, licensed in Georgia (12883) and active in the NPI registry since October 2017. He is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1073023636
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameKEVIN MONTGOMERYCredential: PA-C
Location Address2174 N DRUID HILLS RD NEAtlanta, GA 30329-3102
Mailing Address2174 N Druid Hills Rd NeAtlanta, GA 30329-3102
Phone(404) 785-5437
Sole ProprietorNo
Enumeration DateOctober 9, 2017
Last NPPES UpdateNovember 3, 20255 updates tracked since enumeration
NPPES CertifiedNovember 3, 2025
✔ NPI 1073023636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in GA · 12883
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 005095 (GA), LPC010470 (GA)
2174 N DRUID HILLS RD NE, Atlanta, GA 30329
Open in Google Maps ↗

Secondary Practice Locations 4

Location 1605 Big Shanty Rd NW Ste 300Kennesaw, GA 30144-3646 · Phone (404) 785-5437
Location 2859 Mount Vernon Hwy NE Ste 300Atlanta, GA 30328-4255 · Phone (404) 785-5437
Location 31001 Johnson Ferry RdAtlanta, GA 30342-1605 · Phone (404) 785-5437
Location 42220 N Druid Hills Rd NEAtlanta, GA 30329-3117 · Phone (404) 785-5437

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Montgomery Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACOB A HUMPHREY MD
Pediatrics (Pediatric Nephrology)
2174 N DRUID HILLS RD NE
ATLANTA, GA 30329
Dekalb County (404) 785-5437
ERIN E GUSTAFSON M.S., CCC-SLP
Speech-Language Pathologist
2174 N DRUID HILLS RD NE
ATLANTA, GA 30329
Dekalb County (404) 785-7022
MS. ELIZABETH JANE LACKEY CPNP
Nurse Practitioner (Pediatrics)
2174 N DRUID HILLS RD NE
ATLANTA, GA 30329
Dekalb County (404) 785-2897
DR. MADELEINE HEBERT MCLAUGHLIN MD
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
2174 N DRUID HILLS RD NE
ATLANTA, GA 30329
Dekalb County (404) 785-5437
MS. STEPHANIE PENDLEY CPNP
Nurse Practitioner (Pediatrics)
2174 N DRUID HILLS RD NE
ATLANTA, GA 30329
Dekalb County (404) 785-8821
ANA KUCELIN RDN, LDN
Dietitian, Registered
2174 N DRUID HILLS RD NE
ATLANTA, GA 30329
Dekalb County (404) 785-5437
MIA CHRISTINA CANELLAS CPNP
Nurse Practitioner (Pediatrics)
2174 N DRUID HILLS RD NE
ATLANTA, GA 30329
Dekalb County (404) 785-5437
DR. VIVEK K SHENOY MD
Pediatrics (Pediatric Gastroenterology)
2174 N DRUID HILLS RD NE
ATLANTA, GA 30329
Dekalb County (404) 785-5437

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Montgomery's NPI number?

The NPI number for Kevin Montgomery is 1073023636. It was assigned to this individual provider in the NPPES registry on October 9, 2017.

Where is Kevin Montgomery located?

Kevin Montgomery practices at 2174 N Druid Hills Rd NE, Atlanta, GA 30329. The listed phone number is (404) 785-5437.

What is Kevin Montgomery's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kevin Montgomery enrolled in Medicare?

Yes. Kevin Montgomery is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Montgomery was last updated on November 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.