Individual provider Active NPI

Kelly A Cody, CRNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Decatur, AL
National Provider Identifier
1679388557
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-164567 Issued in AL
Practice address
1615 Kathy LN SW Ste 102
Decatur, AL 35603-1026
Phone
(256) 701-5651
Fax
(256) 429-9411
NPI assigned
Feb 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-164567 AL Primary

Addresses

Primary practice location

1615 Kathy LN SW Ste 102
Decatur, AL 35603-1026

Mailing address

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 288-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250305000827 AL Practitioner - Nurse Practitioner 8325569585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Behavioral Health IncGroup PAC ID 7416194113, 109 clinicians

Practice addresses (Care Compare)

1985 Al Hwy 157
Suite B
Cullman, AL 35058-1124
Phone (256) 775-8824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-164567ALMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health, Inc. Psychiatric/Mental Health CurrentSince Feb 19, 2025 Accepting new patients

Locations

1985 AL Highway 157
Ste B
Cullman, AL 35058
Phone (256) 300-2595

1615 Kathy Ln SW
Ste 102
Decatur, AL 35603
Phone (256) 686-4441

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

25850 Main St
Ardmore, TN 38449
Phone (931) 427-4050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1679388557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-288-3333",
            "fax_number": "256-288-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 KATHY LN SW STE 102",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031026",
            "telephone_number": "256-701-5651",
            "fax_number": "256-429-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODY",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "CRNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-164567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.