Kelli L Pellegrini, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1436 Issued in OR

Practice address

142 SW 2ND Ave
Canby, OR 97013-4152

Phone

(503) 266-5411

Fax

(503) 266-5415

NPI assigned

Mar 19, 2007

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 OR

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

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cornerstone Clinical Services PCGroup PAC ID 3274523378, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Cornerstone Clinical Services PC

  • Community/Behavioral Health Agency
  • Milwaukie, OR
  • NPI 1093892895
  Medicare reassignment Care Compare group NPD
• Cornerstone Clinical Services, Inc

  dba Cornerstone

  • Community/Behavioral Health Agency
  • Lawton, OK
  • NPI 1184786238
  NPD
• Amanda S. Warren, M.D. P.C.

  • Family Medicine Physician
  • Canby, OR
  • NPI 1740337088
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1477677730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 682",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "97013",
            "telephone_number": "503-266-5411",
            "fax_number": "503-266-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SW 2ND AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970134152",
            "telephone_number": "503-266-5411",
            "fax_number": "503-266-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINI",
        "first_name": "KELLI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sehoon Park
• Leah Parsley, L.M.T.
• Kyle Passey, DPT
• Patrick J Gregg MD PC
• Rita Patterson, DMD
• Robin Louis Perez, PMHNP
• Donald D Perman Jr., D.M.D.
• Anne Phan, OTR/L, MSOT
• Britney Rae Phillips
• Elizabeth Sue Pierce-Green, PMHNP-BC

• Clinical Psychologist in Canby, OR
• Providers in Canby, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.