Individual provider Active NPI

Jemma Small, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1821462425
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2697802 Issued in FL
Practice address
2884 Moonstone BND
Kissimmee, FL 34758-2543
Phone
(407) 922-4282
NPI assigned
Nov 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP2697802 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2697802 FL Primary

Addresses

Primary practice location

2884 Moonstone BND
Kissimmee, FL 34758-2543

Mailing address

2884 Moonstone BND
Kissimmee, FL 34758-2543
Phone (407) 922-4282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160525001194 FL Practitioner - Nurse Practitioner 2163711516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osceola Mental Health IncGroup PAC ID 2062313703, 14 clinicians

Practice addresses (Care Compare)

206 Park Place Blvd
Kissimmee, FL 34741-2344
Phone (407) 846-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2697802FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osceola Mental Health Inc CurrentSince Nov 1, 2021 Accepting new patients
Valour Mental Wellness Psychiatric/Mental Health CurrentSince Apr 20, 2025 Accepting new patients

Locations

200 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 846-0023

206 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 846-0023

2940 Pleasant Hill Rd
Kissimmee, FL 34746
Phone (407) 846-0023

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1821462425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2884 MOONSTONE BND",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347582543",
            "telephone_number": "407-922-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2884 MOONSTONE BND",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347582543",
            "telephone_number": "407-922-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "JEMMA",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2697802",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2697802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.