Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MARY MONTGOMERY PA-C
NPI 1225950488
Physician Assistant in Bloomington, IN

Active since July 29, 2026
2100 S LIBERTY DR, BLOOMINGTON, IN 47403(812) 676-4500 Get Directions Write a Review

NPPES record added: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mary Montgomery Pa-c NPPES

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

MARY MONTGOMERY PA-C (NPI 1225950488) is an individual physician assistant in Bloomington, Indiana, licensed in Indiana (10005406A) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1225950488
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMARY MONTGOMERYCredential: PA-C
Location Address2100 S LIBERTY DRBloomington, IN 47403-5147
Mailing Address2100 S Liberty DrBloomington, IN 47403-5147 · (812) 676-4500
Sole ProprietorNo
Enumeration DateJuly 29, 2026
NPPES CertifiedJuly 29, 2026
NPI 1225950488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in IN · 10005406A
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2100 S LIBERTY DR, Bloomington, IN 47403

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 Mary Montgomery's NPI number?

The NPI number for Mary Montgomery is 1225950488. It was assigned to this individual provider in the NPPES registry on July 29, 2026.

Where is Mary Montgomery located?

Mary Montgomery practices at 2100 S Liberty Dr, Bloomington, IN 47403. The listed phone number is (812) 676-4500.

What is Mary Montgomery's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Mary Montgomery was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days 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.