Katina Kelly, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0810007806 Issued in VA

Practice address

1010 Cedar Hill Church Rd
Jonesville, VA 24263-7219

Phone

(507) 226-5759

NPI assigned

Jun 18, 2007

Last updated

Apr 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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 VA

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

Merit-based Incentive Payment System (MIPS)

Final score

84.28 of 100Reported as group

Quality

67.11

Improvement activities

40

Cost

74.56

Medicare enrollment (NPD)

Enrolled

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.

• Deer Oaks Southeast LLC

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1619112612

  VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1306041595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 CEDAR HILL CHURCH RD",
            "city": "JONESVILLE",
            "state": "VA",
            "postal_code": "242637219",
            "telephone_number": "507-226-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 CEDAR HILL CHURCH RD",
            "city": "JONESVILLE",
            "state": "VA",
            "postal_code": "242637219",
            "telephone_number": "507-226-5759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Yager Ave",
            "address_2": "STE. 5",
            "address_purpose": "LOCATION",
            "city": "LA Grange",
            "state": "KY",
            "postal_code": "400311060",
            "country_code": "US",
            "telephone_number": "502-589-1100",
            "fax_number": "502-589-8771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATINA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810007806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Sue Jones, BS
• Thomas Randolph Jones, DMD
• Jonesville Drug Company Inc.
• Jonesville Rescue Squad Inc
• Melissa Nicole Keene, M.D.
• Stuart Laningham, D.D.S.
• Allison Lawson, PHARM.D.
• Savannah Nashay Lebarre
• Lee County Dental Clinic
• Lee County Integrated Care

• Psychologist in Jonesville, VA
• Providers in Jonesville, VA by specialty
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.