Kelly Ann Schmidt, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002411 Issued in CT

Practice address

16 Main St
Ellington, CT 06029-3360

Phone

(860) 871-5402

NPI assigned

Aug 12, 2010

Last updated

Aug 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kelly a. Schmidt, PH.D., LLC

  • Clinical Psychologist
  • Ellington, CT
  • NPI 1104653344
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1073828117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 WAVERLY ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102516",
            "telephone_number": "860-402-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MAIN ST",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293360",
            "telephone_number": "860-871-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Russell, LCSW
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• Ronald Harvey Scherick, DDS
• Denise Ann Scheuy, LPC
• Ronald J Seagrave
• Doreen Seitz, PT
• Erum Shahab, M.D.
• Nashe Smith, CCC-SLP
• Loree Soloway, RPH

• Clinical Psychologist in Ellington, CT
• Providers in Ellington, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.