Lance P Kelley, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

34698 Issued in TX

Practice address

1600 Providence Dr
Waco, TX 76707-2261

Phone

(254) 313-4200

Fax

(254) 313-4531

NPI assigned

Jan 3, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heart of Texas Community Health Center, Inc.Group PAC ID 1153370242, 106 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.

• Heart of Texas Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Waco, TX
  • NPI 1568191492
  Medicare reassignment Care Compare group NPD
• Heart of Texas Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Waco, TX
  • NPI 1164409926
  NPD
• Heart of Texas Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Temple, TX
  • NPI 1992685218
  NPD

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1598069767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "LANCE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-03",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342932601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith C. Warren, PH.D., P.C.
• Kristin Alexandria Keith, DO
• Kari Tyler Kelder
• Sierra Danniel Keller, PHARMD
• Breanna Michelle Kelley
• Ashley Mechelle Kelly
• Jack Kelly, DMD
• Mendy Kelly, LCSW
• Samuel Kelly
• Shannon Marie Kelly, SLP

• Clinical Psychologist in Waco, TX
• Providers in Waco, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.