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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

KELLY MARICE ROSZAK PMHNP-BC
NPI 1992635510
Nurse Practitioner - Psychiatric/Mental Health in Burns, TN

Active since May 23, 2026PECOS Enrolled
1127 OLD EAST SIDE RD, BURNS, TN 37029(216) 235-1084 Get Directions Write a Review

NPPES record added: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Marice Roszak Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY MARICE ROSZAK PMHNP-BC (NPI 1992635510) is an individual psychiatric/mental health provider in Burns, Tennessee, licensed in Tennessee (42264) and active in the NPI registry since May 2026. She is enrolled in Medicare PECOS and maintains a secondary practice location in Brentwood.

NPPES Registry Identity

NPI1992635510
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKELLY MARICE ROSZAKCredential: PMHNP-BC
Location Address1127 OLD EAST SIDE RDBurns, TN 37029-5662
Mailing Address1127 Old East Side RdBurns, TN 37029-5662 · (216) 235-1084
Phone(216) 235-1084
Sole ProprietorNo
Enumeration DateMay 23, 2026
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1992635510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in TN · 42264
Also ListedRegistered NurseTaxonomy 163W00000X · License 265015 (TN)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 42264 (TN)
1127 OLD EAST SIDE RD, Burns, TN 37029
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Other Names 1

Former Name (1)Kelly Marice Haynes Pmhnp

Secondary Practice Location 1

Location 15511 Virginia Way Ste 300Brentwood, TN 37027-7611 · Phone (615) 994-1000 · Fax (615) 994-0100

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Marice Roszak Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37029 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Roszak's NPI number?

The NPI number for Kelly Roszak is 1992635510. It was assigned to this individual provider in the NPPES registry on May 23, 2026. The provider is also known as Kelly Marice Haynes Pmhnp.

Where is Kelly Roszak located?

Kelly Roszak practices at 1127 Old East Side Rd, Burns, TN 37029. The listed phone number is (216) 235-1084.

What is Kelly Roszak's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kelly Roszak enrolled in Medicare?

Yes. Kelly Roszak is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Roszak was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days 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.