SD KELLY LLC
NPI 1285448928
Psychologist in Athens, GA

Active since February 04, 2025
1150 S MILLEDGE AVE STE 4, ATHENS, GA 30605(706) 389-0974 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sd Kelly Llc NPPES

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

SD KELLY LLC (NPI 1285448928) is a healthcare organization registered as a psychologist in Athens, Georgia and active in the NPI registry since February 2025. The organization lists Shannon Kelly, Owner, as its authorized official.

NPPES Registry Identity

NPI1285448928
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameSD KELLY LLC
Location Address1150 S MILLEDGE AVE STE 4Athens, GA 30605-6723
Mailing Address1150 S Milledge Ave Ste 4Athens, GA 30605-6723 · (706) 389-0974
Organization SubpartNo
Authorized OfficialShannon KellyOwner · (706) 389-0974
Enumeration DateFebruary 4, 2025
NPPES CertifiedFebruary 4, 2025
✔ NPI 1285448928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
1150 S MILLEDGE AVE STE 4, Athens, GA 30605

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sd Kelly Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sd Kelly LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1679710594
250 NORTH AVE
Athens, GA 30601
(706) 389-6789
✔ PECOS✔ Accepts Medicare2.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Sd Kelly LLC's NPI number?

The NPI number for Sd Kelly LLC is 1285448928. It was assigned to this organization in the NPPES registry on February 4, 2025.

Where is Sd Kelly LLC located?

Sd Kelly LLC is located at 1150 S Milledge Ave Ste 4, Athens, GA 30605. The listed phone number is (706) 389-0974.

What is Sd Kelly LLC's specialty?

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

Is Sd Kelly LLC enrolled in Medicare?

Yes. Sd Kelly LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sd Kelly LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Sd Kelly LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Sd Kelly LLC was last updated on February 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.