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

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

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: July 19, 2026.

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

On this page

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.