MONTGOMERY MEDCORP, INC.
NPI 1619061702
Pediatrics in Montgomery, WV

NPI Status: Active since October 03, 2006

Contact Information

401 6TH AVE
MONTGOMERY, WV
ZIP 25136
Phone: (304) 442-5151

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  • Organization
  • Pediatrics
  • Accepts Insurance
  • CLIA Number: 51D2291872
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 10-16-2027

About MONTGOMERY MEDCORP, INC.

This page provides the complete NPI Profile along with additional information for Montgomery Medcorp, Inc., a pediatrician established in Montgomery, West Virginia operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1619061702 assigned on October 2006. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Angela Sizemore (Business Office Director)

NPI
1619061702
Provider Name
MONTGOMERY MEDCORP, INC.
Entity Type
Organization
Location Address
401 6TH AVE MONTGOMERY, WV 25136
Location Phone
(304) 442-5151
Mailing Address
401 6TH AVE MONTGOMERY, WV 25136
Mailing Phone
(304) 442-5151
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-03-2006
Last Update Date
08-22-2020
Code Navigator

A pediatrician like Montgomery Medcorp, Inc. is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Deductible Silver 5000 $3 Generic Drugs - HMO
  • Low Deductible Silver 5000 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Platinum Zero $5 Generic Drugs - HMO
  • Platinum Zero $5 Generic Drugs + Adult Vision & Fitness - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANGELA SIZEMORE

Authorized Official Title
BUSINESS OFFICE DIRECTOR
Authorized Official Phone
(304) 442-1251

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
4000066000MEDICAID (05)WV 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
51D2291872
Facility Type
Physician Office
Certificate Effective Date
October 17, 2025
Certificate Expiration Date
October 16, 2027
Laboratory Director
DR. SAMMAR ATASSI
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Montgomery Medcorp, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for MONTGOMERY MEDCORP, INC.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1619061702, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
1
Doubled → 2
Pos 4
9
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
1
Doubled → 2
Pos 8
7
Unchanged
Pos 9
0
Doubled → 0
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 0 → 0 1 → 2 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 2 + 9 + 0 + 6 + 2 + 7 + 0 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1619061702.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Ophthalmology
401 6TH AVE, SUITE 110
MONTGOMERY, WV 25136
Emergency Medicine
401 6TH AVE
MONTGOMERY, WV 25136
Emergency Medicine
401 6TH AVE
MONTGOMERY, WV 25136
Physician Assistant
401 6TH AVE, SUITE 102
MONTGOMERY, WV 25136
Anesthesiology
401 6TH AVE
MONTGOMERY, WV 25136
Family Medicine
401 6TH AVE, D303
MONTGOMERY, WV 25136
Internal Medicine
401 6TH AVE, SUITE 102
MONTGOMERY, WV 25136
Nurse Practitioner
401 6TH AVE
MONTGOMERY, WV 25136
Family Medicine
401 6TH AVE
MONTGOMERY, WV 25136
Pharmacist
401 6TH AVE
MONTGOMERY, WV 25136
Pharmacist
401 6TH AVE
MONTGOMERY, WV 25136
Nurse Practitioner (Family)
401 6TH AVE
MONTGOMERY, WV 25136
Physician Assistant (Medical)
401 6TH AVE
MONTGOMERY, WV 25136
Allergy & Immunology
401 6TH AVE, SUITE 303D
MONTGOMERY, WV 25136
Internal Medicine
401 6TH AVE, SUITE 301
MONTGOMERY, WV 25136
Family Medicine
401 6TH AVE
MONTGOMERY, WV 25136
Occupational Therapy Assistant
401 6TH AVE
MONTGOMERY, WV 25136
Optometrist
401 6TH AVE, SUITE 110
MONTGOMERY, WV 25136
Physician Assistant
401 6TH AVE
MONTGOMERY, WV 25136
Pediatrics
401 6TH AVE, SUITE 100
MONTGOMERY, WV 25136

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619061702, enumerated as an "organization" on October 03, 2006.

The provider is located at 401 6TH AVE MONTGOMERY, WV 25136 and the phone number is (304) 442-5151.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: CareSource, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.