SHANON DAVID MONTGOMERY NP
NPI 1710347901
Nurse Practitioner in Iron Mountain, MI

Q: What is Shanon Montgomery's NPI number?

The NPI number for Shanon Montgomery is 1710347901. It was assigned to this individual provider in the NPPES registry on March 1, 2016.

Q: What is Shanon Montgomery's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Shanon Montgomery was last updated on February 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.

Active since March 01, 2016PECOS Enrolled

440 WOODWARD AVE, IRON MOUNTAIN, MI 49801(906) 776-9040(906) 774-7279 Get Directions Write a Review

NPPES record last updated: February 14, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 14, 2020, Mar 14, 2016, Mar 1, 2016 (3 updates tracked since 2016).

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About Shanon David Montgomery Np NPPES

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

SHANON DAVID MONTGOMERY NP (NPI 1710347901) is an individual nurse practitioner in Iron Mountain, Michigan, licensed in Michigan (4704217286) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710347901

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameSHANON DAVID MONTGOMERYCredential: NP

Location Address440 WOODWARD AVEIron Mountain, MI 49801-4631

Mailing AddressPo Box 22487Green Bay, WI 54305-2487 · (920) 445-7222 · Fax (920) 445-7289

Phone(906) 776-9040

Fax(906) 774-7279

Sole ProprietorNo

Enumeration DateMarch 1, 2016

Last NPPES UpdateFebruary 14, 20203 updates tracked since enumeration

✔ NPI 1710347901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MI · 4704217286

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

440 WOODWARD AVE, Iron Mountain, MI 49801

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Other Identifiers 1

OtherAG0216095American Academy Of Nurse Practitioners

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shanon David Montgomery Np 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.

Medicare Billing Reassignment

Medicare enrollment records show Shanon Montgomery reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Oconto Hospital & Medical Center, Inc.

33 mi

Rural Health

106 S SCHOOL RD
Daggett, MI 49821

Reassigned Medicare billing, Michigan enrollment
37 clinicians in this Medicare group

NPI 1043668643 (906) 753-2155

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49801 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409

DME-Orthotic Devices · category DF010N

1 supplier15 claims390 services$5.71 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$19.54 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier36 claims36 services$7.74 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers20 claims20 services$113.66 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers16 claims16 services$184.98 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DANIEL BRIAN JOHNSON NP

Nurse Practitioner (Family)