Kelcie Marie Small

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

6437 Rucker Rd Ste D
Indianapolis, IN 46220-4868

Phone

(317) 405-9016

Fax

(800) 654-4116

NPI assigned

Sep 23, 2018

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Pediatric Specialty Associates, Inc

  • Early Intervention Provider Agency
  • Indianapolis, IN
  • NPI 1336212638
  NPD (past)
• Pediatric Specialty Associates, Inc

  • Early Intervention Provider Agency
  • Indianapolis, IN
  • NPI 1346628492
  NPD (past)

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

{
    "created_epoch": "1537660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665187200000",
    "number": "1922582188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 LAKESIDE DR",
            "city": "PITTSBORO",
            "state": "IN",
            "postal_code": "461679548",
            "telephone_number": "317-363-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6437 RUCKER RD STE D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204868",
            "telephone_number": "317-405-9016",
            "fax_number": "800-654-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "KELCIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-23",
        "last_updated": "2022-10-08",
        "certification_date": "2022-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody James Small, DPT
• Cristin Small
• Isabella Sophia Small
• Jeanna Ann Small, COTA
• Kathleen Marie Small, NP
• Rebecca R Small, MD
• Sarah K Small, PSYD
• Shayne M Small, MD
• Toni-Marie Small, DDS
• Whitney Small, BCBA

• Developmental Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Developmental Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.