Individual provider Active NPI

Donald Craig Kerley, PSY.D.

  • Psychologist
  • Norcross, GA
National Provider Identifier
1215010665
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY002840 Issued in GA
Practice address
3949 Holcomb Bridge Rd
Suite 202
Norcross, GA 30092-2207
Phone
(770) 449-0082
Fax
(678) 623-8234
NPI assigned
Oct 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY002840 GA
Psychologist 103T00000X PSY002840 GA Primary

Addresses

Primary practice location

3949 Holcomb Bridge Rd
Suite 202
Norcross, GA 30092-2207

Mailing address

3949 Holcomb Bridge Rd
Suite 202
Norcross, GA 30092-2207
Phone (770) 449-0082

Other identifiers 2

IdentifierTypeStateIssuer
10053301OtherGAAMERIGROUP ID NUMBER
52841596 002OtherGABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY002840GAMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1215010665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 202",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922207",
            "telephone_number": "770-449-0082",
            "fax_number": "678-623-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 202",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922207",
            "telephone_number": "770-449-0082",
            "fax_number": "678-623-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERLEY",
        "first_name": "DONALD",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY002840",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP ID NUMBER",
            "identifier": "10053301",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52841596 002",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.