DR. SHANE ANNA KELLEY PHD
NPI 1053694372
Psychologist in Reno, NV

Active since September 22, 2011Opted out of Medicare · through Nov 23, 2027
5421 KIETZKE LN, SUITE 101, RENO, NV 89511(775) 853-3797(855) 754-6250 Get Directions Write a Review

NPPES record last updated: April 28, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Shane Anna Kelley Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANE ANNA KELLEY PHD (NPI 1053694372) is an individual psychologist in Reno, Nevada and active in the NPI registry since September 2011. She has opted out of Medicare through November 23, 2027.

NPPES Registry Identity

NPI1053694372
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. SHANE ANNA KELLEYCredential: PHD
Location Address5421 KIETZKE LN, SUITE 101Reno, NV 89511-3027
Mailing Address5421 Kietzke Ln, Suite 101Reno, NV 89511-3027 · (775) 853-3797 · Fax (855) 754-6250
Fax(855) 754-6250
Sole ProprietorYes
Enumeration DateSeptember 22, 2011
Last NPPES UpdateApril 28, 2014
NPI 1053694372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License 0990 (NV)
5421 KIETZKE LN, Reno, NV 89511

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Shane Anna Kelley Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 23, 2025 through November 23, 2027.

Opt-Out Effective DateNovember 23, 2025
Opt-Out In Effect ThroughNovember 23, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
5421 KIETZKE LN, SUITE 101
RENO, NV 89511
Psychologist (Clinical)
5421 KIETZKE LN, SUITE 202
RENO, NV 89511
Psychologist (Cognitive & Behavioral)
5421 KIETZKE LN, STE 101
RENO, NV 89511
Counselor (Mental Health)
5421 KIETZKE LN, 202
RENO, NV 89511
Psychologist (Cognitive & Behavioral)
5421 KIETZKE LN, SUITE 101
RENO, NV 89511
Clinical Neuropsychologist
5421 KIETZKE LN, SUITE 202
RENO, NV 89511
Psychologist (Clinical)
5421 KIETZKE LN, SUITE 202
RENO, NV 89511
Psychologist (Clinical)
5421 KIETZKE LN, SUITE 101
RENO, NV 89511

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Kelley's NPI number?

The NPI number for Shane Kelley is 1053694372. It was assigned to this individual provider in the NPPES registry on September 22, 2011.

Where is Shane Kelley located?

Shane Kelley practices at 5421 Kietzke Ln Suite 101, Reno, NV 89511. The listed phone number is (775) 853-3797.

What is Shane Kelley's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Shane Kelley enrolled in Medicare?

No. Shane Kelley has opted out of Medicare through November 23, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Shane Kelley was last updated on April 28, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.