Ryan Michael Kelley, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

214914 Issued in LA

Practice address

126 Rue Colette
Thibodaux, LA 70301-5628

Phone

(985) 625-0023

Fax

(985) 625-0022

NPI assigned

Sep 14, 2020

Last updated

Sep 14, 2020By the provider in NPPES

Sex

Male

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

Enrolled in LA

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, 2020

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Psychological Health Care of South LouisianaGroup PAC ID 5395916571, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Psychological Health Care of South Louisiana

  • Clinical Neuropsychologist
  • Houma, LA
  • NPI 1134418502
  Medicare reassignment Care Compare group NPD
• Deepblue Wellness LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Metairie, LA
  • NPI 1518460211
  Medicare reassignment NPD
• Rodriguez Clinic and Foundation LLC

  • Psychiatry Physician
  • Metairie, LA
  • NPI 1609001999
  Medicare reassignment NPD

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1346855517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 RUE COLETTE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015628",
            "telephone_number": "985-625-0023",
            "fax_number": "985-625-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 RUE COLETTE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015628",
            "telephone_number": "985-625-0023",
            "fax_number": "985-625-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "214914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Just Health
• Just Health
• Paritosh Kafle, MD
• KCS Transportation LLC
• Ebara T Keeling, BA
• Carolyn Kennedy
• David R Kesterson, PA-C
• Kidney Center of South Louisiana, AMC
• Christopher Kimble, CRNA
• Elisabeth King, BA

• Psychiatric/Mental Health Nurse Practitioner in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.