Kelly Theim Hurst, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

5914 Hubbard Dr
Rockville, MD 20852-4823

Phone

(301) 468-4849

NPI assigned

Aug 16, 2018

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2018 through Oct 1, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• National Center for Weight and Wellness

  • Psychologist
  • Washington, DC
  • NPI 1134664493
  NPD (past)

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1851871040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5914 HUBBARD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5914 HUBBARD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524823",
            "telephone_number": "301-468-4849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 19th St NW Ste 450",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200366114",
            "country_code": "US",
            "telephone_number": "202-223-3077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HURST",
        "first_name": "KELLY",
        "middle_name": "THEIM",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Dale Hurley, MD
• Ellie Hurley
• Kathleen Brooks Hurley, APRN
• Dequisha Hursey
• Amber Hurst
• Lonnie Hurst
• Amaya Hurtado
• Fatima Zehra Husain, M.D.
• Emmanuel Sewekan Husitode
• Bryia Huskey

• Psychologist in Rockville, MD
• Providers in Rockville, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.