KELLY ANN NYE SMALL
NPI 1063198810
Nurse Practitioner - Psychiatric/Mental Health in Hagerstown, MD
About Kelly Ann Nye Small NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY ANN NYE SMALL (NPI 1063198810) is an individual psychiatric/mental health provider in Hagerstown, Maryland, licensed in Maryland (R119093) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kelly Ann Nye Small is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kelly Small reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hagerstown, MD 21740
- Reassigned Medicare billing, Maryland enrollment
- 9 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 21740 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HAGERSTOWN, MD 21740
HAGERSTOWN, MD 21740
HAGERSTOWN, MD 21740
HAGERSTOWN, MD 21740
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Small's NPI number?
The NPI number for Kelly Small is 1063198810. It was assigned to this individual provider in the NPPES registry on June 26, 2023.
Where is Kelly Small located?
Kelly Small practices at 120 N Potomac St, Hagerstown, MD 21740. The listed phone number is (301) 790-4938.
What is Kelly Small's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Kelly Small enrolled in Medicare?
Yes. Kelly Small is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kelly Small's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Small reassigns Medicare benefits to Black Rock Integrative Medicine (Hagerstown, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Small's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelly Small was last updated on June 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelly Ann Nye Small · NPI 1063198810
Psychiatric/Mental Health physician in Hagerstown, Maryland. Individual provider, active in the CMS NPPES registry since June 26, 2023.
## Identity
- **NPI:** 1063198810 (Entity type: Individual)
- **Enumerated:** June 26, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** R119093 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 120 N POTOMAC ST, Hagerstown, MD 21740-4810
- **Phone:** (301) 790-4938
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Black Rock Integrative Medicine (NPI 1285102764, Hagerstown, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** June 26, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1063198810) · Data from the CMS NPPES public registry.