Kelly D Brill, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0031831 Issued in OH

Practice address

159 Crocker Park Blvd Ste 400
Westlake, OH 44145-8147

Phone

(440) 864-2802

Fax

(440) 287-6137

NPI assigned

Jul 28, 2021

Last updated

Feb 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

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.

• Songbird Psychiatric and Recovery Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Westlake, OH
  • NPI 1023797586
  Medicare reassignment NPD Authorized official
• Nancy Duff-Boehm, PH.D.

  • Clinical Psychologist
  • North Olmsted, OH
  • NPI 1730105362
  Medicare reassignment

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1275206039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 CROCKER PARK BLVD STE 400",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441458147",
            "telephone_number": "440-864-2802",
            "fax_number": "440-287-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 CROCKER PARK BLVD STE 400",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441458147",
            "telephone_number": "440-864-2802",
            "fax_number": "440-287-6137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Oak Tree Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "OH",
            "postal_code": "441316914",
            "country_code": "US",
            "telephone_number": "440-864-2802",
            "fax_number": "440-287-6137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRILL",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.384208",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0031831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Cameron Bressi, DO
• Theodore K Brewer, AA-C
• Colleen M Brezine, CNM
• Bridge Rehab and Performance LLC (Bridge Rehab and Performance)
• Alicia Rose Bright, MSW, LSW
• Theresa Lynn Brixius, LPC
• Stephanie Brode, DO
• Shylah Brooks
• Aaron Brown
• Ashley Marie Brown, NP

• Psychiatric/Mental Health Nurse Practitioner in Westlake, OH
• Providers in Westlake, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.