AUTUMN KATHRYN MONTGOMERY (FNP-C) – Nurse Practitioner, NPI 1770065187
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for AUTUMN KATHRYN MONTGOMERY (FNP-C)
130 W Armstrong Ave
Deland, FL 327205861
Phone: (317) 670-6794
Type: Location
6041 SW 54TH ST STE 200
OCALA, FL 344745521
Phone: (352) 857-8417
Fax: (352) 414-1324
Type: Mailing
614 W 14th St
Marion, IN 469532158
Phone: (765) 662-3701
Type: Location
451 S AMELIA AVE
DELAND, FL 327245917
Phone: (317) 670-6794
Type: Mailing
3775 N LECANTO HWY
BEVERLY HILLS, FL 344653559
Phone: (352) 746-0600
Type: Mailing
5534 SAINT JOE RD
FORT WAYNE, IN 468353328
Phone: (317) 670-6794
Type: Mailing
3518 S LAFOUNTAIN ST
KOKOMO, IN 469023803
Phone: (765) 453-4667
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $212.
Total Amount is formed as General ($212) + Research ($0) + Ownership ($0) = $212.
Last reported payment date: 2023-08-14 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($53).
Total Amount
$212
General + Research + Ownership
Payments
10
Total payment records
General Amount
$212
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-14
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-12-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20181228000815 | I | Nurse Practitioner | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32720)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IN | |
| Internal Medicine | WA | |
| Internal Medicine | IA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | IL |
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