Shonta Simmons, ITFS BS CBRS PROF.

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

611 S George St
Goldsboro, NC 27530-5715

Phone

(919) 330-4802

Fax

(919) 751-2320

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

Practice roles

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.

• Simmons Early Intervention Therapy, LLC

  • Developmental Therapist
  • Goldsboro, NC
  • NPI 1356566756
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1295869246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S GEORGE ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275305715",
            "telephone_number": "919-330-4802",
            "fax_number": "919-751-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S GEORGE ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275305715",
            "telephone_number": "919-330-4802",
            "fax_number": "919-751-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SHONTA",
        "name_prefix": "Mrs.",
        "credential": "ITFS BS CBRS PROF.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301201K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Shoemake
• Barbara H. Shoestock, OTR/L
• Ajay Iyengar Shreenath, MD
• Simmons Early Intervention Therapy, LLC
• Millicent Murray Simmons, RD, LDN
• Simplicity Counseling Services PLLC
• Morgan P Sinclair
• Skill Creations
• Skill Creations, Inc.
• Skill Creations, Inc.

• All providers in Goldsboro, NC
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.