Kanieshawa Kelly, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

T-5465 Issued in MS

Practice address

PO Box 157a
Whitfield, MS 39193-0157

Phone

(601) 685-0918

NPI assigned

Jul 1, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1396581286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157A",
            "city": "WHITFIELD",
            "state": "MS",
            "postal_code": "391930157",
            "telephone_number": "601-685-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 157A",
            "city": "WHITFIELD",
            "state": "MS",
            "postal_code": "391930157",
            "telephone_number": "601-685-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KANIESHAWA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "T-5465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther W Jiles
• Caryn Alison Johnson, FNP-BC, PMHNP-BC
• Cynthia Johnson, PH.D.
• Laura M Johnson, PMHNP
• Joel Jung, DO
• Zinat K Khandekar, M.D.
• Dakota Weston Kilcrease, DO
• Jenise Kohnke, PH.D.
• William Alex Kujawski, DO
• Betty Lang, C. F. N. P.

• Psychiatry Physician in Whitfield, MS
• Providers in Whitfield, MS by specialty
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.