KELLY LANE BLAIR (PH.D) – Clinical Psychologist, NPI 1891711131
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
400 CLINICAL PSYCHOLOGIST in TN
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Provider Addresses for KELLY LANE BLAIR (PH.D)
45, Sycamore Street, Jackson, Madison County, Tennessee, 38301, United States
SUITE 604
JACKSON, TN 383054436
Phone: (731) 660-8759
Type: Mailing
West Forest Avenue, Hicksville, Jackson, Madison County, Tennessee, 38301, United States
JACKSON, TN 383013901
Phone: (731) 425-4930
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.
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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: 2006-11-20
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20061120000246 | I | Clinical Psychologist | TN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation | 523 | 494 | $0 |
| 96137 | Administration of psychological or neuropsychological test, each additional 30 minutes | 96 | 41 | $0 |
| 96156 | Assessment of health behavior | 94 | 90 | $0 |
| 90834 | Psychotherapy, 45 minutes | 71 | 21 | $0 |
| 96136 | Administration of psychological or neuropsychological test, first 30 minutes | 58 | 58 | $0 |
Insurance plans in this area (ZIP 38305)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHOLOGIST, CLINICAL | TN | 96118 | Neuropsychological testing, interpretation, and report by psychologist or physician per hour | 67 | 16 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | PA | |
| Vascular Surgery, General Surgery | MD | |
| Family Practice | TN | |
| Nurse Practitioner | TN | |
| Cardiovascular Disease (Cardiology) | DC | |
| Internal Medicine, Gastroenterology | TN | |
| Cardiovascular Disease (Cardiology) | TN | |
| - | TN | |
| Nurse Practitioner | TN | |
| Pulmonary Disease, Internal Medicine, Critical Care (Intensivists), Critical Care (Intensivists) | AL |
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