SAMUEL K KELLEY M.D. - NPI 1154368199 - Psychiatry & Neurology in Paducah, KY

Q: What is Samuel Kelley's NPI number?

The NPI number for Samuel Kelley is 1154368199. It was assigned to this individual provider in the NPPES registry on May 31, 2006.

Q: What is Samuel Kelley's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Kelley was last updated on November 3, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Samuel K Kelley M.d. NPPES

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

SAMUEL K KELLEY M.D. (NPI 1154368199) is an individual child & adolescent psychiatry provider in Paducah, Kentucky, licensed in Kentucky (59615) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Louisville School Of Medicine (1987).

NPPES Registry Identity

NPI1154368199

Entity TypeIndividualMale

Primary Taxonomy2084P0804X

Provider Legal NameSAMUEL K KELLEYCredential: M.D.

Location Address2327 NEW HOLT RDPaducah, KY 42001-7404

Mailing Address5050 Village Square Dr Ste BPaducah, KY 42001-7552 · (270) 534-5128

Phone(270) 534-5128

Fax(270) 477-0007

Sole ProprietorNo

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1987

Enumeration DateMay 31, 2006

Last NPPES UpdateNovember 3, 20253 updates tracked since enumeration

NPPES CertifiedNovember 3, 2025

✔ NPI 1154368199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

Licenses✔ Licensed in KY · 59615✔ Licensed in MA · 72427

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

2327 NEW HOLT RD, Paducah, KY 42001

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Secondary Practice Locations 2

Location 15050 Village Square Dr Ste BPaducah, KY 42001-7552 · Phone (617) 877-8292

Location 22520 New Holt Rd Ste IPaducah, KY 42001-7547 · Phone (270) 558-3919

Other Identifiers 1

Other1154368199MA · Npi

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel K Kelley M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810889813

PECOS Enrollment IDI20250501000574

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

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

MS. HANNAH KLEIN LCSW

Social Worker (Clinical)