Kelly Cristen O'Laughlin, MT-BC, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

4515 Premier Dr Ste 402a
High Point, NC 27265-8356

Phone

(336) 702-1255

Fax

(336) 802-2201

NPI assigned

Nov 24, 2010

Last updated

Oct 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wake Forest Health Network LLC

  dba Atrium Health Wake Forest Baptist Pediatrics - Greensboro

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1477785756
  Medicare reassignment NPD
• Wake Forest Health Network LLC

  dba Atrium Health Wake Forest Baptist Behavioral Medicine - Premier

  • Psychologist
  • High Point, NC
  • NPI 1982084307
  NPD

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1669774618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DR STE 402A",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658356",
            "telephone_number": "336-702-1255",
            "fax_number": "336-802-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 E 7th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282046301",
            "country_code": "US",
            "telephone_number": "704-275-5342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "418 W Mountain St # B",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272842534",
            "country_code": "US",
            "telephone_number": "704-275-5342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5175 Old Clemmons School Rd.",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271029087",
            "country_code": "US",
            "telephone_number": "704-275-5342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'LAUGHLIN",
        "first_name": "KELLY",
        "middle_name": "CRISTEN",
        "name_prefix": "Dr.",
        "credential": "MT-BC, PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-24",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4074",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001256",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in High Point, NC
• Providers in High Point, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.