Jennifer Ann Kelly

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW005108 Issued in GA

Practice address

2940 Johnson Ferry Rd Ste B-127
Marietta, GA 30062-8361

Phone

(678) 637-7166

Fax

(770) 414-0804

NPI assigned

May 22, 2020

Sex

Female

Sole proprietor

Yes

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 GA

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 Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Transitions, LLCGroup PAC ID 7911083365, 8 clinicians

Practice addresses (Care Compare)

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.

• Mindful Transitions, LLC

  • Clinical Social Worker
  • Marietta, GA
  • NPI 1619188273
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1609499714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 JOHNSON FERRY RD STE B-127",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628361",
            "telephone_number": "678-637-7166",
            "fax_number": "770-414-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 JOHNSON FERRY RD STE B-127",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628361",
            "telephone_number": "678-637-7166",
            "fax_number": "770-414-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Gladney Kellner, NP-C
• Kira Kellogg, MSW, LMSW
• Dianne Flint Kelly, MS
• Holli Maria Kelly, LMFT
• James Brian Kelly, PA-C
• Onika Kelly, MD
• Raelynn Marie Kelly
• Gunjan Kelotra-Jindia, MD
• Caroline Elyse Kemp, PA
• Elizabeth Kemp, MD

• Clinical Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.
• 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.