Christopher E Kelley, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY5175 Issued in CO

Practice address

6535 S Dayton St Ste 3650
Greenwood Village, CO 80111-6135

Phone

(720) 695-3369

NPI assigned

Sep 23, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Waymark Psychological Services, LLC

  • Psychologist
  • Greenwood Village, CO
  • NPI 1013540640
  Medicare reassignment NPD Authorized official
• Dr. Sunda Friedman Tebockhorst Psychologicl Services, LTD

  • Psychologist
  • Lafayette, CO
  • NPI 1548657877
  NPD (past)

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1386295277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 S DAYTON ST STE 3650",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801116135",
            "telephone_number": "720-695-3369",
            "fax_number": "720-780-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 S DAYTON ST STE 3650",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801116135",
            "telephone_number": "720-695-3369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6680 Gunpark Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803013349",
            "country_code": "US",
            "telephone_number": "720-387-8458",
            "fax_number": "720-306-5190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "E",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSYC13966",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY5175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSYC.0013966",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Anne Kegerries, REGESTERED NURSE
• Michael Arlie Keirns, D.P.T
• Keith Ladner, MD, Inc.
• Jessica Keller
• Melissa D Keller, PSY.D.
• John Curtis Kelly
• William Charles Kelly, MD
• Myron Richard Kem, M.D.
• Hope Ann Kemper, CRNA
• Shannon L Kennealey, LCSW

• Psychologist in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.