Kelly Lynn Sprout, M.D.
Individual provider Active NPI Psychiatry Physician · Sandusky, OH
NPI 1659422129 · NPPES record last updated Dec 5, 2019
Key facts
- NPI
- 1659422129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 72088 (OH)
- Practice address
- 1925 Hayes Ave
Sandusky, OH 44870-4737 - Phone
- (419) 557-5177
- NPI assigned
- Jan 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Ohio State University College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Firelands Regional Medical Center
Practice addresses (Care Compare)
1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-7400
Hospital & facility affiliations
- Firelands Regional Medical Center
- Fisher-Titus Hospital
- Bellevue Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060201000097 | OH | Practitioner - Psychiatry | 2769496561 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72088 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allwell Behavioral Health Services | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/allwell/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 72088 | OH | Yes |
Addresses
Primary practice location
1925 Hayes Ave
Sandusky, OH 44870-4737
Mailing address
1925 Hayes Ave
Sandusky, OH 44870-4737
Phone (419) 557-5177
Other providers in Sandusky, OH
- Eryn Mackenzie Spicer
- James Warren Spicer II
- Laura Spicer
- Sarah Elizabeth Spicer
- Trent Arthur Sponseller
- Lynn Anne Stackhouse-Roby
- Sara Stahl
- Star Chiropractic LLC
- State of Ohio Office of Budget and Management State Accounting
- Stay Wellness, Therapy, and Consulting
All providers in Sandusky, OH · Psychiatry Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.