Individual provider Active NPI

Kenneth Randall Starkey, PSYD

  • Clinical Psychologist
  • London, KY
National Provider Identifier
1730386772
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1062 Issued in KY
Practice address
1308 West Fifth Street
London, KY 40741
Phone
(606) 877-3479
Fax
(606) 877-3479
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1062 KY
Psychologist 103T00000X 1062 KY
Addiction (Substance Use Disorder) Psychologist 103TA0400X 0385 KY
Clinical Psychologist 103TC0700X 1062 KY Primary

Addresses

Primary practice location

1308 West Fifth Street
London, KY 40741

Mailing address

PO Box 1975
London, KY 40743-1975
Phone (606) 877-3479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9743 Brooklyns Way S
Semmes, AL 36575-6280

PO Box
Suite 850607
Mobile, AL 36685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1062KYMDMental Health Counselor
0385KYMDAddiction (Substance Use Disorder) Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Psychology Services Psychologist CurrentSince Jan 7, 2013 Accepting new patients
State of Alabama Dept of Finace Past Accepting new patients
Ford Psychiatry Past Accepting new patients
State of Alabama Dept of Finance Past Accepting new patients
Winds of Change Psychological Services of Mobile Clinical Past Accepting new patients

Locations

6313 Piccadilly Square Dr
#2
Mobile, AL 36609
Phone (251) 343-9200

6313 Piccadilly Square Dr
Ste 2
Mobile, AL 36609
Phone (251) 343-9200

Organizations & group practices 5

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1730386772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1975",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407431975",
            "telephone_number": "606-877-3479",
            "fax_number": "606-877-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 WEST FIFTH STREET",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "40741",
            "telephone_number": "606-877-3479",
            "fax_number": "606-877-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARKEY",
        "first_name": "KENNETH",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "1062",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "1062",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "0385",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.