Individual provider Active NPI

Kayla Jean Kelley, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Coal Grove, OH
National Provider Identifier
1013594332
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3015926 Issued in KY
Practice address
225 Carlton Davidson LN
Coal Grove, OH 45638-2924
Phone
(740) 533-6280
Fax
(740) 353-1662
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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 3015926 KY Primary

Addresses

Primary practice location

225 Carlton Davidson LN
Coal Grove, OH 45638-2924

Mailing address

901 Washington St
Portsmouth, OH 45662-3944
Phone (740) 354-7702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210420001215 OH Practitioner - Nurse Practitioner 5890103782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shawnee Mental Health Center Inc 25 clinicians

Practice addresses (Care Compare)

225 Carlton Davidson LN
Coal Grove, OH 45638-2924
Phone (740) 533-0648

Hospital & facility affiliations

  • Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Mental Health Center, Inc. CurrentSince Jan 10, 2022 Accepting new patients
Shawnee Mental Health Center, Inc. CurrentSince Jan 10, 2022 Accepting new patients
Shawnee Mental Health Center, Inc. Past Accepting new patients
Ovp Health Care Inc Past Accepting new patients
Ovp Health Care Inc Past Accepting new patients
Shawnee Mental Health Center, Inc. Past Accepting new patients
Ohio Valley Physicians Inc Past Accepting new patients
Shawnee Mental Health Center, Inc. Past Accepting new patients

Locations

225 Carlton Davidson Ln
Coal Grove, OH 45638
Phone (740) 354-7702

901 Washington St
Portsmouth, OH 45662
Phone (740) 354-7702

192 Chestnut Ridge Rd
West Union, OH 45693
Phone (937) 544-5581

Interoperability endpoints

  • Direct secure messaging: kayla.kelley.p1@direct.shawneemhc.nextgenshare.com

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1013594332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623944",
            "telephone_number": "740-354-7702",
            "fax_number": "740-353-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CARLTON DAVIDSON LN",
            "city": "COAL GROVE",
            "state": "OH",
            "postal_code": "456382924",
            "telephone_number": "740-533-6280",
            "fax_number": "740-353-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KAYLA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3015926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coal Grove, OH

Sources for this page

Verify at the official NPI Registry.