Individual provider Active NPI

Kelly Moore Sutherland, DO

  • Psychiatry Physician
  • Lexington, KY
National Provider Identifier
1205331600
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
04849 Issued in KY
Practice address
3581 Harrodsburg Rd Ste 350
Lexington, KY 40513-1140
Phone
(859) 313-6333
Fax
(859) 313-3484
NPI assigned
Mar 27, 2018
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R4811 KY
Psychiatry Physician 2084P0800X 04849 KY Primary

Addresses

Primary practice location

3581 Harrodsburg Rd Ste 350
Lexington, KY 40513-1140

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

Other practice location 1

245 Fountain Ct Ste 225
Lexington, KY 40509-1888
Phone (859) 323-6021

Other identifiers 1

IdentifierTypeStateIssuer
7100616800MedicaidKY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230914001682 KY Practitioner - Psychiatry 4880027127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3581 Harrodsburg Rd
Suite 350
Lexington, KY 40513-1140
Phone (859) 313-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R4811KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckyone Health Medical Group, Inc. Psychiatry CurrentSince Oct 1, 2023 Accepting new patients
Kentucky Medical Services Foundation, Inc Psychiatry PastSince Sep 1, 2019 Accepting new patients
University of Kentucky PastSince Sep 1, 2019 Accepting new patients
Kentuckyone Health Medical Group, Inc. Psychiatry PastSince Aug 27, 2023 Accepting new patients

Locations

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

Interoperability endpoints

  • Direct secure messaging: kmoore18654@ukhcdirect.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1205331600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 HARRODSBURG RD STE 350",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131140",
            "telephone_number": "859-313-6333",
            "fax_number": "859-313-3484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Fountain Ct Ste 225",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405091888",
            "country_code": "US",
            "telephone_number": "859-323-6021",
            "fax_number": "859-323-1194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "KELLY",
        "middle_name": "MOORE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "R4811",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "04849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100616800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.