Jessica Shantz, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704267746 Issued in MI

Practice address

8150 Old 13 Mile Rd
Warren, MI 48093-8700

Phone

(800) 395-3223

Fax

(248) 620-6405

NPI assigned

Nov 27, 2018

Last updated

Aug 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ismail B Sendi MD PCGroup PAC ID 4688674534, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Ismail B. Sendi, MD, PC

  dba New Oakland Child-Adolescent and Family Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clarkston, MI
  • NPI 1609882067
  Medicare reassignment Care Compare group NPD
• Ismail B. Sendi, MD, PC

  dba New Oakland Child-Adolescent and Family Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton Township, MI
  • NPI 1932370988
  NPD

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1790255248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "800-395-3223",
            "fax_number": "248-620-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 OLD 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938700",
            "telephone_number": "800-395-3223",
            "fax_number": "248-620-6405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28800 Ryan Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480924272",
            "country_code": "US",
            "telephone_number": "586-582-0500",
            "fax_number": "586-834-2231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANTZ",
        "first_name": "JESSICA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704267746",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704267746",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Shaheen, DDS
• Philip Jeffrey Shaheen, M.D.
• Sherwin Shaji
• Ganeshkumar Shanmugasundaram, RPT
• Tim Shannahan, PT
• Shar, Inc.
• Ghanem Sharabi, MD
• Gaurav Sharma
• Sharon R. Rose LMSW Caac Counseling Services LLC (no)
• Heba Habib Shathaya, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Warren, MI
• Providers in Warren, 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 Aug 30, 2024; 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.