DR. KELLY CARL FELLER (PHD, LCSW) – Clinical Social Worker, NPI 1134417132

DR. KELLY CARL FELLER (PHD, LCSW) is a healthcare provider. based in North salt lake, Utah. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials PHD, LCSW. They hold a License No. 7057775-3501 (UT). The NPI Number for DR. KELLY CARL FELLER (PHD, LCSW) is 1134417132

Main info

Male
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. KELLY CARL FELLER (PHD, LCSW)
NPI
1134417132
Phone
(801) 809-1049
Address
1048 E FAIRWAY DR
Enumeration Date
12 July 2011
Last Update Date
14 July 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8016839340
Graduation Year
2011 (15 years ago)
PAC ID
8325282247
Group Practice PAC ID
6800030727
Professional Enrollment ID
I20130916000606
Address ID
UT840106249BO270XXSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

965 CLINICAL SOCIAL WORKER in UT

Provider Addresses for DR. KELLY CARL FELLER (PHD, LCSW)

  • 1048 E FAIRWAY DR

    NORTH SALT LAKE, UT 840543056

    Phone: (801) 809-1049

    Type: Mailing

  • 537 W 2600 S

    SUITE 203

    BOUNTIFUL, UT 840107779

    Phone: (801) 809-1049

    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: 2013-09-16

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
I20130916000606IClinical Social WorkerUTTBD

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 hour14112$0
View full utilization report →

Insurance plans in this area (ZIP 84054)

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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: 6800030727View full group profile
NameSpecialtyState
Clinical Social WorkerUT
Marriage And Family TherapistUT
Clinical Social WorkerUT
Nurse PractitionerUT

Reviews

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Frequently asked questions

What is the standard ID for DR. KELLY CARL FELLER (PHD, LCSW) in the U.S.?
In the U.S., DR. KELLY CARL FELLER (PHD, LCSW) is identified by NPI 1134417132.
Does the public listing show DR. KELLY CARL FELLER (PHD, LCSW) as active?
DR. KELLY CARL FELLER (PHD, LCSW)'s NPI record reflects an active status in NPPES.
How should patients interpret DR. KELLY CARL FELLER (PHD, LCSW)'s specialty?
The extract shows Clinical Social Worker for DR. KELLY CARL FELLER (PHD, LCSW). Clinical services aligned with this taxonomy classification.
Can patients visit DR. KELLY CARL FELLER (PHD, LCSW) in North Salt Lake, Utah?
For routing, start with North Salt Lake, Utah for DR. KELLY CARL FELLER (PHD, LCSW), then verify phone and hours locally.
Why is information missing for DR. KELLY CARL FELLER (PHD, LCSW)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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