Jeanette Maritza Simmons, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2002030478 Issued in MO

Practice address

3505 Frederick Ave
Saint Joseph, MO 64506-2914

Phone

(816) 387-2300

Fax

(816) 387-2769

NPI assigned

Sep 20, 2006

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

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Guidance Center for Behavioral HealthcareGroup PAC ID 6800707571, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• State of Missouri

  • Psychiatric Hospital
  • Kansas City, MO
  • NPI 1730134495

  W-2 Managing Employee

  CMS ownership

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.

• Family Guidance Center for Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Saint Joseph, MO
  • NPI 1932225141
  Medicare reassignment Care Compare group
• Family Guidance Center for Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Saint Joseph, MO
  • NPI 1164964235
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1457458432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062914",
            "telephone_number": "816-387-2300",
            "fax_number": "816-387-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062914",
            "telephone_number": "816-387-2300",
            "fax_number": "816-387-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JEANETTE",
        "middle_name": "MARITZA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2002030478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498333509",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sigsco Inc.
• Kristen Kay Siler-Kline, LCSW
• Silver Linings Healthcare, Inc.
• Abigayle L Silvy, MAADC II
• Ada Louise Silvy, ACSW, LCSW, MSW
• Whitney Danielle Simmons, FNP
• Haley Simpson, CRNA
• Justin Aaron Simpson, D.O.
• Zachary Thomas Siress, DO
• SJ3 Op Chateau LLC

• Clinical Psychologist in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.