Joseph Paul Montgomery, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704318966 Issued in MI

Practice address

24715 Little Mack Ave Ste 200
Saint Clair Shores, MI 48080-3207

Phone

(586) 777-9000

Fax

(586) 777-0823

NPI assigned

Dec 22, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Wayne State University School of Medicine, 2020

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmontgomery296946@direct.hfhs.org
• Direct secure messaging: lifestancehealth.josephmontgomery@150339.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baddigam Family Psychiatric Associates PLLC

  • Psychiatry Physician
  • Clinton Township, MI
  • NPI 1093899569
  Medicare reassignment NPD
• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130

  Professional

  NPD
• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1295866135
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1104155126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-777-9000",
            "fax_number": "586-777-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-777-9000",
            "fax_number": "586-777-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JOSEPH",
        "middle_name": "PAUL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401011520",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704318966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "75091042",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joram O Mogaka, MD
• Brilio Conrado Mojares, MD
• Gail Ellen Molinari, D.D.S., M.S., M.S.
• Joanna Maria Monaco, LLMSW
• Courtney Lynn Monreal, LMSW
• Kristie L Moonan, OTR
• Alexandria Moore
• Jacquan Moore, MS
• Jamisha Moore
• Kara Elizabeth Moore

• Psychiatric/Mental Health Nurse Practitioner in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.