Kelley Gill, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 9562 Issued in FL

Practice address

1752 NW 3Rd Ter
#213
Fort Lauderdale, FL 33311-4885

Phone

(203) 430-9108

NPI assigned

Nov 7, 2015

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 FL

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

Medicare enrollment (NPD)

Enrolled

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.

• Martin D Segel PH.D.

  dba Martin D. Segel, Ph.D. & Associates

  • Psychologist
  • Coconut Creek, FL
  • NPI 1891974317
  Medicare reassignment NPD
• Mtca Psychological Services P.a.

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1740552322
  Medicare reassignment NPD
• Palm Beach Psychology Group, LLC

  • Clinical Psychologist
  • Boca Raton, FL
  • NPI 1487085809
  Medicare reassignment NPD

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

{
    "created_epoch": "1446854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1083087456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 NW 3RD TER",
            "address_2": "#213",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333114885",
            "telephone_number": "203-430-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 NW 3RD TER",
            "address_2": "#213",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333114885",
            "telephone_number": "203-430-9108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3512 Quentin Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112344245",
            "country_code": "US",
            "telephone_number": "718-942-6595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "KELLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 9562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arma Jean Gilead
• Flavio Gilio Andrade de Meneses, MD
• Amar Gill
• Carl C Gill, MD
• Howard S Gill
• Meera Gill
• Jerry N Gilles, MD
• Dominique Sierra Gillespie, MSN, CRNP, WHNP-BC
• Katherine Dawn Gillespie, CNM
• Lauryn Salassi Gilliam, MS, PHD CANDIDATE

• Clinical Psychologist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.