Judy Ann Kerley, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

GA02400 Issued in GA

Practice address

4411 Suwanee Dam Rd
Suite 920
Suwanee, GA 30024-8701

Phone

(678) 714-9590

Fax

(678) 714-9535

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 1, 2024 through Feb 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jeff Weber, Ed.D., P.C.

  • Psychologist
  • Suwanee, GA
  • NPI 1245566603
  NPD (past)
• Mary Grace Thomas, PH.D.,P.C.

  • Psychologist
  • Suwanee, GA
  • NPI 1073848891
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316019029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 SUWANEE DAM RD",
            "address_2": "SUITE 920",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300248701",
            "telephone_number": "678-714-9590",
            "fax_number": "678-714-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SUWANEE DAM RD",
            "address_2": "SUITE 920",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300248701",
            "telephone_number": "678-714-9590",
            "fax_number": "678-714-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERLEY",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "GA02400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Kelliny, PA
• Jena Kelly, OTR/L
• Lauren K Kelly, MA, LMFT
• Laprinces Elaine Kennard, BCBA, LBA
• Kurtis Kepfer, PT
• Anjana Khadka
• Farah S Khan, DMD
• Panyavee Khan, MD
• Lilly Khokhlan
• Kim Khong

• Clinical Psychologist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.