Individual provider Active NPI

Kelly Nicole Morgan, PSYD

  • Clinical Neuropsychologist
  • Madison, WI
National Provider Identifier
1316580517
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3147 Issued in OR
Practice address
744 Heartland TRL
Madison, WI 53717-1982
Phone
(608) 294-6008
Fax
(608) 824-2675
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 3147 OR Primary

Addresses

Primary practice location

744 Heartland TRL
Madison, WI 53717-1982

Mailing address

744 Heartland TRL
Madison, WI 53717-1982
Phone (608) 294-6008

Other practice location 1

1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone (608) 252-8000

Other identifiers 1

IdentifierTypeStateIssuer
1316580517MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmorgan386437@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191127002077 OR Practitioner - Clinical Psychologist 8729411079
I20201110001046 WI Practitioner - Clinical Psychologist 8729411079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

744 Heartland TRL
Madison, WI 53717-1982
Phone (608) 294-6088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Professional Center CurrentSince May 17, 2020 Accepting new patients
Dean Health Systems, Inc. CurrentSince Oct 26, 2020 Accepting new patients
Dean Health Systems, Inc CurrentSince Oct 26, 2020 Accepting new patients

Locations

3735 S River Pkwy
Portland, OR 97239
Phone (503) 972-7090

4207 SE Woodstock Blvd
Portland, OR 97206
Phone (503) 312-6005

744 Heartland Trl
Madison, WI 53717
Phone (608) 294-6008

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1316580517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 HEARTLAND TRL",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171982",
            "telephone_number": "608-294-6008",
            "fax_number": "608-824-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 HEARTLAND TRL",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171982",
            "telephone_number": "608-294-6008",
            "fax_number": "608-824-2675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1313 Fish Hatchery Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151911",
            "country_code": "US",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "3147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316580517",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmorgan386437@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kmorgan386437@direct-ehr-ssmhc.com",
            "address_1": "744 Heartland Trl",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537171982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "address_1": "744 Heartland Trl",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537171982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.