JOHN T. SMALL (M.D.) – Addiction Medicine (Family Medicine) Physician, NPI 1619948692

JOHN T. SMALL (M.D.) is a healthcare provider. based in Haggerhill, Kentucky. specializing in Addiction Medicine (Family Medicine) Physician. They hold the professional credentials M.D.. They hold a License No. 21474 (KY). The NPI Number for JOHN T. SMALL (M.D.) is 1619948692

Main info

Male
Sole Proprietor
46 Years Of Experience
Accepts Medicare Assignment
Name
JOHN T. SMALL (M.D.)
NPI
1619948692
Phone
(606) 297-1644
Address
3802 KY-321
Enumeration Date
30 January 2006
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Secondary Phone
6066668404
Graduation Year
1980 (46 years ago)
PAC ID
1355237397
Group Practice PAC ID
7012285497
Professional Enrollment ID
I20040225001086
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for JOHN T. SMALL (M.D.)

  • 3802 KY-321

    HAGGERHILL, KY 41222

    Phone: (606) 297-1644

    Type: Location

  • PO BOX 757

    CAMPTON, KY 413010757

    Phone: (817) 797-6767

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-02-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040225001086IEmergency MedicineKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 41222)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012285497View full group profile
NameSpecialtyState
Nurse PractitionerKY
-KY

Reviews

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Frequently asked questions

What unique ID ties claims to JOHN T. SMALL (M.D.)?
NPI 1619948692 is assigned to JOHN T. SMALL (M.D.) under the national enumeration system.
Is JOHN T. SMALL (M.D.) active in the national directory?
JOHN T. SMALL (M.D.)'s public NPI profile is in an active state.
What field does JOHN T. SMALL (M.D.) work in?
You can think of JOHN T. SMALL (M.D.) as practicing within Addiction Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
What location shows for JOHN T. SMALL (M.D.)?
We surface Haggerhill, Kentucky for JOHN T. SMALL (M.D.) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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