NPIMap

Organization Active NPI

Ronald L. Kelley PSC

Doing business as Kelley Psychiatric Clinic

  • Child & Adolescent Psychiatry Physician
  • Paducah, KY
National Provider Identifier
1891772059
Registry record updated Jan 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
RONALD L. KELLEY PSC
Doing business as
Kelley Psychiatric Clinic
Practice address
6025 Kentucky Dam Rd
Paducah, KY 42003-9472
Phone
(270) 898-4044
Fax
(270) 898-4045
NPI assigned
Dec 29, 2005
Last updated
Jan 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2012

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

Authorized official

Name
Dr. Ronald L. Kelley, M.D.NPI 1033196019
Title
Ceo
Phone
(270) 898-4044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU Primary

Addresses

Primary practice location

6025 Kentucky Dam Rd
Paducah, KY 42003-9472

Mailing address

PO Box 3126
Paducah, KY 42002-3126
Phone (270) 898-4044

Other identifiers 1

IdentifierTypeStateIssuer
64151434MedicaidKY

Other names 1

  • Kelley Psychiatric Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325462400000",
    "number": "1891772059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3126",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420023126",
            "telephone_number": "270-898-4044",
            "fax_number": "270-898-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 KENTUCKY DAM RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420039472",
            "telephone_number": "270-898-4044",
            "fax_number": "270-898-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD L. KELLEY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2012-01-02",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-898-4044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64151434",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelley Psychiatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.