KALLYE JOANAH RENNER (PHD) – Clinical Psychologist, NPI 1093299299

KALLYE JOANAH RENNER (PHD) is a healthcare provider. based in Florence, Kentucky. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 265759 (KY). The NPI Number for KALLYE JOANAH RENNER (PHD) is 1093299299

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
KALLYE JOANAH RENNER (PHD)
NPI
1093299299
Phone
(859) 282-0119
Address
7426 US 42 STE 106
Enumeration Date
24 September 2018
Last Update Date
11 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8592820119
Graduation Year
2018 (8 years ago)
PAC ID
9032529839
Group Practice PAC ID
4981976222
Professional Enrollment ID
I20201106000153
Address ID
KY410422056FL7426X42XX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

253 CLINICAL PSYCHOLOGIST in KY

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Provider Addresses for KALLYE JOANAH RENNER (PHD)

  • Old United States Highway 42, Florence, Boone County, Kentucky, 41042, United States

    FLORENCE, KY 410422056

    Phone: (859) 282-0119

    Mailing address matches the actual address.

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: 2020-11-06

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
I20201106000153IClinical PsychologistKYTBD

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 41042)

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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: 4981976222View full group profile
NameSpecialtyState
-KY
-KY
Mental Health CounselorKY
Mental Health CounselorKY
Clinical Social WorkerKY
-KY
Clinical Social WorkerKY

Reviews

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Frequently asked questions

How is KALLYE JOANAH RENNER (PHD) identified in CMS data?
CMS-hosted NPPES data lists KALLYE JOANAH RENNER (PHD) with NPI 1093299299.
Does the file indicate KALLYE JOANAH RENNER (PHD) is practicing under active NPI?
Directory data currently reports KALLYE JOANAH RENNER (PHD) as active.
What taxonomy line describes KALLYE JOANAH RENNER (PHD)?
For research purposes, treat KALLYE JOANAH RENNER (PHD) as Clinical Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
Where is KALLYE JOANAH RENNER (PHD) based?
KALLYE JOANAH RENNER (PHD) is tied to Florence, Kentucky in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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