Jennifer Kelly, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4623 Issued in MA

Practice address

1 Merrimac Landing
Ste 17
Newburyport, MA 01950

Phone

(978) 463-3030

Fax

(978) 463-0009

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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 MA

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

State licenses

Practice roles

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.

• Port Psychological Assoc Inc

  • Psychologist
  • Newburyport, MA
  • NPI 1669532198
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831259365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 MAIN ST",
            "city": "ROWLEY",
            "state": "MA",
            "postal_code": "01964",
            "telephone_number": "978-463-3030",
            "fax_number": "978-463-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERRIMAC LANDING",
            "address_2": "STE 17",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "01950",
            "telephone_number": "978-463-3030",
            "fax_number": "978-463-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Keane, LMHC
• Michael Burton Keaney, N.P.
• Barbara Allen Keeler
• Akshay Keerthy
• Robert Keller
• Sarah Kelly
• Katelyn Kenny
• Kimberly Kersten, DO
• Kids Airway Dentist, P.C.
• Brenna Kiel

• Psychologist in Newburyport, MA
• Providers in Newburyport, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.