Kelly T Clouse, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME110938 Issued in FL

Practice address

100 Deerfield Preserve Blvd
St Augustine, FL 32086-5966

Phone

(904) 823-2896

NPI assigned

Jun 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Psychiatry

Education

University of Iowa, RJ & L Carver College of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.52 of 100Reported as group

Quality

78.57

Promoting interoperability

99

Improvement activities

40

Cost

74

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.clouse@hca5.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memorial Family Practice Associates, LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1598869844
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1932104288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DEERFIELD PRESERVE BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865966",
            "telephone_number": "904-823-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DEERFIELD PRESERVE BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865966",
            "telephone_number": "904-823-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUSE",
        "first_name": "KELLY",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "46974",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME110938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Montagu Cline, D.M.D.
• Joshua Cline, PHARMD
• Shannon Cline, LMHC
• Shelby H Cline, MD
• Linda Sue Clonch, M.D.
• Michelle Marie Cloutier, LMT
• Jamila Cloward
• Bethany Clubb, PT, DPT
• Coamex Therapy Services
• Coast Dental P.a. (Coast Dental-Anastasia Island)

• Psychiatry Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.