KISHA SMALLEY FNP
NPI 1124645395
Nurse Practitioner - Primary Care in Mcdonough, GA
About Kisha Smalley Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KISHA SMALLEY FNP (NPI 1124645395) is an individual primary care provider in Mcdonough, Georgia, licensed in Georgia (F07200350) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS.
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 (PECOS)
Kisha Smalley Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kisha Smalley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Florence, AL 35630
- Reassigned Medicare billing, Georgia enrollment
- 3 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 30252 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
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kisha Smalley's NPI number?
The NPI number for Kisha Smalley is 1124645395. It was assigned to this individual provider in the NPPES registry on July 2, 2020.
Where is Kisha Smalley located?
Kisha Smalley practices at 117 Gambier Cv, Mcdonough, GA 30252. The listed phone number is (904) 536-3032.
What is Kisha Smalley's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Kisha Smalley enrolled in Medicare?
Yes. Kisha Smalley is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kisha Smalley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kisha Smalley reassigns Medicare benefits to Remedy Behavioral Health, LLC (Florence, AL). 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 Kisha Smalley'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 Kisha Smalley was last updated on July 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Kisha Smalley, FNP · NPI 1124645395
Primary Care physician in Mcdonough, Georgia. Individual provider, active in the CMS NPPES registry since July 2, 2020.
## Identity
- **NPI:** 1124645395 (Entity type: Individual)
- **Enumerated:** July 2, 2020
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** F07200350 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 117 GAMBIER CV, Mcdonough, GA 30252-6273
- **Phone:** (904) 536-3032
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Remedy Behavioral Health, LLC (NPI 1013517317, Florence, AL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 2, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1124645395) · Data from the CMS NPPES public registry.