Dr Katina Kelly, PSYD is a medicare enrolled "Psychologist" provider in Jonesville, Virginia. Her current practice location is
1010 Cedar Hill Church Rd, Jonesville, Virginia. You can reach out to her office (for appointments etc.) via phone at
(507) 226-5759.
Dr Katina Kelly is licensed to practice in Virginia (license number 0810007806) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1306041595.
Healthcare Provider's Profile
Full Name | Dr Katina Kelly |
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Gender | Female |
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Speciality | Psychologist |
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Location | 1010 Cedar Hill Church Rd, Jonesville, Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1306041595
- Provider Enumeration Date: 06/18/2007
- Last Update Date: 04/20/2022
Medicare PECOS Information:
- PECOS PAC ID: 8426445263
- Enrollment ID: I20220426003144
Medical Identifiers
Medical identifiers for Dr Katina Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1306041595 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
103T00000X | Psychologist | 0810007806 (Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Katina Kelly allows following entities to bill medicare on her behalf.
Entity Name | Deer Oaks Southeast Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1619112612 PECOS PAC ID: 7719251875 Enrollment ID: O20170928000739 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Katina Kelly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Katina Kelly, PSYD 1010 Cedar Hill Church Rd, Jonesville, VA 24263-7219 Ph: (507) 226-5759 | Dr Katina Kelly, PSYD 1010 Cedar Hill Church Rd, Jonesville, VA 24263-7219 Ph: (507) 226-5759 |
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