Active NPI
Shontay Latrese Simmons, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Benton Harbor, MI
National Provider Identifier
1710842992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 4704308911
- Practice address
- 1485 M 139
Benton Harbor, MI 49022-5711 - Phone
- (269) 925-0585
- NPI assigned
- Dec 19, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 4704308911 | MI | Primary |
Addresses
Primary practice location
1485 M 139
Benton Harbor, MI 49022-5711
Mailing address
223 S 13TH St
Saginaw, MI 48601-1837
Phone (989) 714-7299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704308911 | MI | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1710842992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 S 13TH ST",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486011837",
"telephone_number": "989-714-7299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 M 139",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490225711",
"telephone_number": "269-925-0585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "SHONTAY",
"middle_name": "LATRESE",
"name_prefix": "Mrs.",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-19",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MI",
"license": "4704308911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.