Kellie Burns, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY5058 Issued in CO

Practice address

4115 Boardwalk Dr
Fort Collins, CO 80525-5945

Phone

(970) 493-4580

Fax

(970) 797-2259

NPI assigned

Jul 29, 2011

Sex

Female

Sole proprietor

No

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 CO

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Neurofeedback Clinic of Northern Colorado LLCGroup PAC ID 6406162353, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Neurofeedback Clinic of Northern Colorado LLC

  • Clinical Social Worker
  • Fort Collins, CO
  • NPI 1659794477
  Medicare reassignment Care Compare group NPD
• Neurofeedback Clinic of Northern Colorado LLC

  • Marriage & Family Therapist
  • Greeley, CO
  • NPI 1760043897
  NPD

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1093093684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 BOARDWALK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255945",
            "telephone_number": "970-493-4580",
            "fax_number": "970-797-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 BOARDWALK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255945",
            "telephone_number": "970-493-4580",
            "fax_number": "970-797-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "KELLIE",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY5058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Burnham & Burnham M.D.P.C.
• Arlie Joachim Burnham, DDS
• Janie Burnham, CMT
• Linda A. Burnham, M.D.
• Allyson Burns, LPC
• Michael J Burns, DPM
• Taylor Burns
• Barbie Burrage, CPM RM
• Joshua Todd Burrer, DPT
• Slaten Burris, EMT

• Clinical Psychologist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.