Individual provider Active NPI

Kellie S. Jones, MA, LPP

  • Clinical Psychologist
  • Lexington, KY
National Provider Identifier
1366626913
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
115833 Issued in KY
Practice address
1450 N Broadway Ste 312
Lexington, KY 40505-3162
Phone
(859) 351-8746
Fax
(859) 873-0966
NPI assigned
Dec 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 115833 KY Primary

Addresses

Primary practice location

1450 N Broadway Ste 312
Lexington, KY 40505-3162

Mailing address

6070 Hidden Away LN
Versailles, KY 40383-8798
Phone (859) 351-8746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
115833KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
We Care Therapy Clinical Past Accepting new patients
Pediatric and Adult Therapy Associates Incorporated Past Accepting new patients

Organizations & group practices 2

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": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1366626913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 HIDDEN AWAY LN",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403838798",
            "telephone_number": "859-351-8746",
            "fax_number": "859-873-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 N BROADWAY STE 312",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405053162",
            "telephone_number": "859-351-8746",
            "fax_number": "859-873-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KELLIE",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "MA, LPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "115833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.