Austin Neel Kelly, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

39255 Issued in TX

Practice address

2401 South 31St Street
Mailstop: Ms-22-103E
Temple, TX 76508

Phone

(254) 725-3874

NPI assigned

May 9, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

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 and National Provider Directory roles.

• Scott & White Clinic

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704
  Medicare reassignment Care Compare group NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796
  NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • College Station, TX
  • NPI 1922061993
  NPD

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

• Scott & White Memorial Hospital

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1477516466
  Care Compare affiliation
• Scott & White Memorial Hospital

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1578502613
  Care Compare affiliation

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1174979231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 SOUTH 31ST STREET",
            "address_2": "MAILSTOP: MS-22-103E",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "76508",
            "telephone_number": "254-725-3874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 SW Morrison St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972051945",
            "country_code": "US",
            "telephone_number": "503-352-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14600 NW Cornell Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97229",
            "country_code": "US",
            "telephone_number": "503-645-3581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "AUSTIN",
        "middle_name": "NEEL",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "39255",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "39255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akelly828486@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 South 31st Street",
            "address_2": "Mailstop: MS-22-103E",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John S Kelley, MD
• Kelly D Kelley, ACA, NBC-H.I.S.
• Shanice Kelley, LCSW
• Hannah Michelle Kellum, RN
• Ashley Kelly, RN
• Emma Marks Kelly, MD
• Guillermo Antonio Kelly
• Shaquita Kelly
• Kelsey Renae Kelso, M.D.
• Robin Kendall, M.D.

• Clinical Psychologist in Temple, TX
• Providers in Temple, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.