Kelly Black, PMHNP-BC
NPI 1912653536 · Psychiatric/Mental Health Nurse Practitioner · Mesa, AZ
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kelly Black, PMHNP-BC is a Psychiatric/Mental Health Nurse Practitioner provider in Mesa, AZ (NPI 1912653536).
Provider details
- NPI number
- 1912653536
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PMHNP-BC
- Sex
- Female
- Sole proprietor
- No
- License
- 56220 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 32205 Snyder LnHomeland, CA 92548-9600Phone: (951) 623-7194
Registry dates
- Enumerated
- 2022-02-22
- Last updated
- 2025-02-06
- Certified
- 2025-02-06
Frequently asked questions
- What is Kelly Black's NPI number?
- Kelly Black's National Provider Identifier (NPI) is 1912653536, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kelly Black's specialty?
- Kelly Black is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kelly Black located?
- Kelly Black's practice location on file with NPPES is 1910 S Stapley Dr Ste 120, Mesa, AZ 85204-6676.
- What is Kelly Black's phone number?
- The practice phone number listed in the NPPES registry for Kelly Black is (602) 341-3303.
- Does Kelly Black accept Medicare?
- Kelly Black is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kelly Black's NPI active?
- Yes — Kelly Black's NPI (1912653536) is active in the NPPES registry as of the last update on 2025-02-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.