DR. KELLY VINEHOUT (PSYD) – Clinical Psychologist, NPI 1134263999

DR. KELLY VINEHOUT (PSYD) is a healthcare provider. based in Woodstock, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 071006683 (IL). The NPI Number for DR. KELLY VINEHOUT (PSYD) is 1134263999

Main info

Female
Sole Proprietor
24 Years Of Experience
Name
DR. KELLY VINEHOUT (PSYD)
NPI
1134263999
Phone
(815) 245-6669
Address
1090 MCCONNELL RD
Enumeration Date
16 February 2007
Last Update Date
11 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8155759675
Graduation Year
2002 (24 years ago)
PAC ID
9830235076
Group Practice PAC ID
9830631068
Professional Enrollment ID
I20091001000508
Address ID
IL600987310WO1090XRDXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for DR. KELLY VINEHOUT (PSYD)

  • 1090 MCCONNELL RD

    WOODSTOCK, IL 600987310

    Phone: (815) 245-6669

    Fax: (815) 334-1640

    Type: Location

  • PO BOX 1861

    WOODSTOCK, IL 600981861

    Phone: (815) 245-6669

    Fax: (815) 334-1640

    Type: Mailing

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: 2009-10-01

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
I20091001000508IClinical PsychologistILTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60098)

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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: 9830631068View full group profile
NameSpecialtyState
Clinical Social WorkerIL
Mental Health CounselorIL
Clinical PsychologistIL
Clinical PsychologistIL

Reviews

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Frequently asked questions

Is there an official ID for DR. KELLY VINEHOUT (PSYD) in U.S. healthcare records?
The official identifier for DR. KELLY VINEHOUT (PSYD) is NPI 1134263999.
Would DR. KELLY VINEHOUT (PSYD) appear as active to a payer?
You can treat DR. KELLY VINEHOUT (PSYD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. KELLY VINEHOUT (PSYD)?
DR. KELLY VINEHOUT (PSYD)'s record emphasizes Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is DR. KELLY VINEHOUT (PSYD) located near Woodstock?
DR. KELLY VINEHOUT (PSYD) currently maps to Woodstock, Illinois in this extract.
Does DR. KELLY VINEHOUT (PSYD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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