Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Ann Nye Small

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1063198810

Kelly Ann Nye Small is a Nurse Practitioner in Hagerstown, Maryland. Qualified in 2023, 3 years ago. Practices with Black Rock Integrative Medicine, a 6-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
3
Licensed in
MD
In the registry since
2023
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Practice location Address checks out

120 N Potomac St
Hagerstown, MD 21740-4810
Phone: (301) 790-4938
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence R119093 (MD)

Record details

NPI number1063198810
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 26, 2023
Last updated in NPPESJune 26, 2023
Certification dateMay 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Black Rock Integrative Medicine — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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