James D Kelly, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4093 Issued in OH

Practice address

11161 Kenwood Rd
Cincinnati, OH 45242-1817

Phone

(513) 769-4600

Fax

(513) 769-0304

NPI assigned

Sep 1, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 18, 2015 through Mar 18, 2027

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Family Success Consortium Inc

  • Psychologist
  • Cincinnati, OH
  • NPI 1275724916

  Clinical

  NPD (past)
• Family Success Consortium Inc

  • Psychologist
  • Cincinnati, OH
  • NPI 1942520648
  NPD (past)
• Lifeway Counseling Centers, Inc.

  • Counseling Psychologist
  • Cincinnati, OH
  • NPI 1902837636
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598867665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11161 KENWOOD RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452421817",
            "telephone_number": "513-769-4600",
            "fax_number": "513-769-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11161 KENWOOD RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452421817",
            "telephone_number": "513-769-4600",
            "fax_number": "513-769-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Kelly, M.D.
• Elizabeth Margaret Ann Kelly, MD
• Emily Katherine Kelly, PA-C
• Jackson Patrick Kelly, MD
• Jaelyn Kelly
• Jennifer Jo Kelly, RN, CNP
• Jerome J Kelly, M.D.
• Joe Kelly
• Jonathan Randall Kelly
• Juleisa Karole Kelly

• Clinical Psychologist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.