Scott A Kelly, ED.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301006856 Issued in MI

Practice address

3125 W Main St
Kalamazoo, MI 49006-2997

Phone

(269) 488-5905

Fax

(269) 488-5906

NPI assigned

Feb 13, 2008

Last updated

Feb 13, 2008By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Diane M KanousGroup PAC ID 0143389031, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Diane M Kanous

  • Counseling Psychologist
  • Kalamazoo, MI
  • NPI 1588837736
  Medicare reassignment Care Compare group NPD
• Scott Kelly & Associates PC

  • Psychologist
  • Kalamazoo, MI
  • NPI 1396885604
  Medicare reassignment Authorized official
• Dorman and Associates PLC

  • Psychologist
  • Kalamazoo, MI
  • NPI 1275737413
  NPD (past)

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1184892051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062997",
            "telephone_number": "269-488-5905",
            "fax_number": "269-488-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062997",
            "telephone_number": "269-488-5905",
            "fax_number": "269-488-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301006856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Thomas Kells, MT-BC
• Jacklyn Kelly
• Keaghan Kelly
• Matthew Kelly, MD
• Norajane Kelly, SLP
• Sheril Kelly, MSW, ACSW
• Timothy L Kelly, MA, LPC
• Kelsea a Howell PLLC (Atlas Counseling & Psychotherapy Services)
• Amanda Kempkers
• Kelsey Kemppainen

• Psychologist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.