DR. KRISTEN KELLEY (PSYD) – Clinical Psychologist, NPI 1154483956

DR. KRISTEN KELLEY (PSYD) is a healthcare provider. based in Jacksonville, Florida. specializing in PSYCHIATRY. They hold the professional credentials PSYD. They hold a License No. PY8745 (FL). The NPI Number for DR. KRISTEN KELLEY (PSYD) is 1154483956

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. KRISTEN KELLEY (PSYD)
NPI
1154483956
Phone
Not provided
Address
4205 BELFORT RD STE 4015
Enumeration Date
15 December 2006
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9043763800
Graduation Year
2003 (23 years ago)
PAC ID
1355580176
Group Practice PAC ID
7315166394
Professional Enrollment ID
I20130626000589
Address ID
FL320816152PO98XXXDRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness85
Years active:19State licenses:2Digital endpointsOther names

1,953 PSYCHIATRY in FL

Provider Addresses for DR. KRISTEN KELLEY (PSYD)

  • 4015, Belfort Road, Jacksonville, Duval County, Florida, 32216, United States

    JACKSONVILLE, FL 322163623

    Phone:

    Type: Mailing

  • PO BOX 748519

    ATLANTA, GA 303748519

    Phone: (904) 376-3800

    Fax: (904) 376-3998

    Type: Mailing

  • 98 NOCATEE VILLAGE DR

    PONTE VEDRA BEACH, FL 320816152

    Phone: (904) 376-3800

    Fax: (904) 390-7392

    Type: Location

  • Sawgrass Village Drive, Palm Valley, Ponte Vedra Beach, Saint Johns County, Florida, United States

    PONTE VEDRA, FL 32082

    Phone: (904) 285-9355

    Fax: (904) 285-8422

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-06-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130626000589IPsychiatryFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour26922$0
View full utilization report →

Insurance plans in this area (ZIP 32216)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7315166394View full group profile

Reviews

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Frequently asked questions

Is DR. KRISTEN KELLEY (PSYD) listed with a National Provider Identifier?
Yes — DR. KRISTEN KELLEY (PSYD) has NPI 1154483956 on file in the registry.
Would DR. KRISTEN KELLEY (PSYD) appear as active to a payer?
You can treat DR. KRISTEN KELLEY (PSYD) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is DR. KRISTEN KELLEY (PSYD)?
DR. KRISTEN KELLEY (PSYD) is associated with Clinical Psychologist in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. KRISTEN KELLEY (PSYD)?
Travel planning: use Jacksonville, Florida as the reference point for DR. KRISTEN KELLEY (PSYD), then confirm.
Can I trust this NPI listing for DR. KRISTEN KELLEY (PSYD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.