MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C) – Emergency Response System Companies, NPI 1760092340

MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C) is a healthcare provider. based in Tulsa, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, AGNP-C. They hold a License No. 24191369 (VA). The NPI Number for MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C) is 1760092340

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C)
NPI
1760092340
Phone
(918) 340-6477
Address
1611 S Utica Ave Ste 101
Enumeration Date
7 August 2020
Last Update Date
5 May 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4787439123110
Graduation Year
2022 (4 years ago)
PAC ID
4385821081
Group Practice PAC ID
9032107479
Professional Enrollment ID
I20230407000074
Address ID
GA312017917MA389XXSTXX301
Data current as of
3 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness85
Years active:5State licenses:10Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C)

  • 1611 S Utica Ave Ste 101

    Tulsa, OK 741044909

    Phone: (918) 340-6477

    Type: Location

  • 866 ORANGE TER

    MACON, GA 312012151

    Phone: (478) 246-1114

    Fax: (478) 202-2488

    Type: Mailing

  • 389 MULBERRY ST STE 200

    MACON, GA 312017917

    Phone: (478) 743-9123

    Type: Location

  • 1445 Woodmont Ln NW Ste 2866

    Atlanta, GA 303182866

    Phone: (478) 246-1114

    Fax: (478) 202-2488

    Type: Location

  • 3780 Eisenhower Pkwy

    Macon, GA 312060800

    Phone: (478) 633-5500

    Type: Location

  • 1900 E ITHICA ST

    BROKEN ARROW, OK 740121820

    Phone: (918) 346-3094

    Type: Mailing

  • 673 PINE ST

    MACON, GA 312012855

    Phone: (478) 743-9123

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-04-07

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230407000074INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes10234$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes2821$0
View full utilization report →

Insurance plans in this area (ZIP 74104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032107479View full group profile
NameSpecialtyState
-GA
N E U R O L O G YGA
N E U R O L O G YGA
N E U R O L O G YGA

Reviews

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Frequently asked questions

What NPI should I save for MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C)?
Save NPI 1760092340 if you need a stable reference for MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C).
Is MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C)'s NPI currently valid?
The extract we use shows MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C) as active.
What kind of provider is MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C)?
The page reflects Emergency Response System Companies for MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C). Clinical services aligned with this taxonomy classification.
Does MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C) practice in Oklahoma?
You will see Tulsa, Oklahoma on file for MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C) alongside any extra practice locations.
Is MR. LARRY ALLEN MONTGOMERY (APRN, AGNP-C) a real provider?
This page reflects official NPPES data for NPI 1760092340. Always confirm identity and privileges with the practice and licensing boards.