Samuel K Kelley, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

59615 Issued in KY

Practice address

5050I Village Square Dr
Paducah, KY 42001-9499

Phone

(270) 898-4044

Fax

(270) 898-4045

NPI assigned

May 31, 2006

Last updated

Aug 22, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Louisville School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Emerald Therapy Center LLCGroup PAC ID 6103241211, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Emerald Therapy Center, LLC

  • Community/Behavioral Health Agency
  • Paducah, KY
  • NPI 1619340387
  Medicare reassignment Care Compare group NPD
• Advanced Behavioral Wellness LLC

  • Psychiatry Physician
  • Paducah, KY
  • NPI 1841049855
  Medicare reassignment NPD
• Emerald Therapy Center, LLC

  dba Emerald Healthcare Group

  • Rural Health Clinic/Center
  • Paducah, KY
  • NPI 1023715281
  NPD

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787356800000",
    "number": "1154368199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050I VILLAGE SQUARE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019499",
            "telephone_number": "270-898-4044",
            "fax_number": "270-898-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050I VILLAGE SQUARE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019499",
            "telephone_number": "270-898-4044",
            "fax_number": "270-898-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SAMUEL",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-08-22",
        "certification_date": "2026-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "59615",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "72427",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154368199",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Keller, DPT
• Rudy Kellett
• Cecilia Kelley-Burt, RBT
• Amber Renee Kelley-Harned, RPH
• Ronald L Kelley, M.D.
• Keith Edward Kelly, M.D.
• Laura Elizabeth Kelso, FNP-BC
• Lauren Kemmerlin
• Tracey Kendall, APSST
• Natasha Jean Kendrick

• Child & Adolescent Psychiatry Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Child & Adolescent Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2026; 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.