Kisha Smalley, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F07200350 Issued in GA

Practice address

117 Gambier CV
McDonough, GA 30252-6273

Phone

(904) 536-3032

NPI assigned

Jul 2, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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 and National Provider Directory roles.

• Remedy Behavioral Health, LLC

  • Psychiatry Physician
  • Florence, AL
  • NPI 1013517317

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1124645395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 GAMBIER CV",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302526273",
            "telephone_number": "904-536-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 GAMBIER CV",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302526273",
            "telephone_number": "904-536-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLEY",
        "first_name": "KISHA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "F07200350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimily Singleton, RN
• Ron W Skelton, RPH
• Chadvina L Skyers, LPC
• Andrew Joseph Slavico, MD
• Carlos A Sloan
• Smart Care Clinic & Wellness Spa LLC
• Smart Mouths Speech Therapy
• Nathaniel Smiley
• Amy D Smith, NP
• Angela Smith

• Primary Care Nurse Practitioner in McDonough, GA
• Providers in McDonough, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.