Individual provider Active NPI

Annick Sheron Kelly, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1184554305
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R203469 Issued in MD
Practice address
10 Jonathan St
Hagerstown, MD 21740-4802
Phone
(240) 486-6756
NPI assigned
May 20, 2026
Last updated
May 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R203469 MD Primary

Addresses

Primary practice location

10 Jonathan St
Hagerstown, MD 21740-4802

Mailing address

10 Jonathan St
Hagerstown, MD 21740-4802
Phone (240) 486-6756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 Jonathan St
Hagerstown, MD 21740-4802

4005 Gelding LN
Olney, MD 20832-1735

9919 Greenbelt Rd
Apt 203
Lanham, MD 20706-2247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R203469MDMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1779235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1184554305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 JONATHAN ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404802",
            "telephone_number": "240-486-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 JONATHAN ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404802",
            "telephone_number": "240-486-6756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANNICK",
        "middle_name": "SHERON",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-20",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R203469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.