Individual provider Active NPI

Kelly Anne Sheperd Riolo, PH.D.

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1902232291
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
3901 Greenspring Ave
Baltimore, MD 21211-1353
Phone
(443) 923-7626
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

3901 Greenspring Ave
Baltimore, MD 21211-1353

Mailing address

1051 Marleigh Cir
Towson, MD 21204-2206
Phone (908) 770-1858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20231219000528 MD Practitioner - Clinical Psychologist 3870943780 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05321MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Nov 7, 2023 Accepting new patients
Kennedy Krieger Associates CurrentSince Nov 7, 2023 Accepting new patients

Locations

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

3901 Greenspring Ave
Baltimore, MD 21211
Phone (443) 923-7630

Organizations & group practices 2

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1902232291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 MARLEIGH CIR",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042206",
            "telephone_number": "908-770-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 GREENSPRING AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111353",
            "telephone_number": "443-923-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPERD RIOLO",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.