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MS. KELLY L GRIGSBY LPC
NPI 1649764366
Counselor - Mental Health in Lagrange, GA

Active since June 16, 2018PECOS Enrolled
1605 VERNON RD STE 1500, LAGRANGE, GA 30240(706) 615-1691 Get Directions Write a Review

NPPES record last updated: November 16, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 16, 2023, Jun 16, 2018 (2 updates tracked since 2018).

About Ms. Kelly L Grigsby Lpc NPPES

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

MS. KELLY L GRIGSBY LPC (NPI 1649764366) is an individual mental health provider in Lagrange, Georgia, licensed in Georgia (008115) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649764366
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. KELLY L GRIGSBYCredential: LPC
Location Address1605 VERNON RD STE 1500Lagrange, GA 30240-4166
Mailing Address103 Christophers WayMidland, GA 31820-6121 · (706) 615-1691
Phone(706) 615-1691
Sole ProprietorYes
Enumeration DateJune 16, 2018
Last NPPES UpdateNovember 16, 20232 updates tracked since enumeration
NPPES CertifiedNovember 16, 2023
✔ NPI 1649764366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in GA · 008115
1605 VERNON RD STE 1500, Lagrange, GA 30240
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kelly L Grigsby Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Grigsby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Doctor On Demand Professionals P C
2,121 mi
Family Medicine
1 CALIFORNIA ST STE 2300
San Francisco, CA 94111
  • Reassigned Medicare billing, Georgia enrollment
  • 18 clinicians in this Medicare group
NPI 1174931448 (800) 997-6196

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

Other Providers at the Same Location NPPES 2

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

KRISTEN NICOLE HAMMOND PA
Physician Assistant
1605 VERNON RD STE 1500
LAGRANGE, GA 30240
Troup County (706) 884-1712
TACARA NICHOLE HEMINGWAY PMHNP-BC
Nurse Practitioner
1605 VERNON RD STE 1500
LAGRANGE, GA 30240
Troup County (706) 884-1712

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 Kelly Grigsby's NPI number?

The NPI number for Kelly Grigsby is 1649764366. It was assigned to this individual provider in the NPPES registry on June 16, 2018.

Where is Kelly Grigsby located?

Kelly Grigsby practices at 1605 Vernon Rd Ste 1500, Lagrange, GA 30240. The listed phone number is (706) 615-1691.

What is Kelly Grigsby's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kelly Grigsby enrolled in Medicare?

Yes. Kelly Grigsby is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Grigsby's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Grigsby reassigns Medicare benefits to Doctor On Demand Professionals P C (San Francisco, CA). The 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 Kelly Grigsby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Grigsby was last updated on November 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.