JERRI KELLEY
NPI 1871029710
Counselor - Addiction (Substance Use Disorder) in Newark, OH
About Jerri Kelley NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JERRI KELLEY (NPI 1871029710) is an individual addiction (substance use disorder) provider in Newark, Ohio, licensed in Ohio (LICDC.161703) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Newark, and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jerri Kelley is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jerri Kelley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Columbus, OH 43213
- Reassigned Medicare billing, Ohio enrollment
- 19 clinicians in this Medicare group
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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jerri Kelley's NPI number?
The NPI number for Jerri Kelley is 1871029710. It was assigned to this individual provider in the NPPES registry on May 11, 2017.
Where is Jerri Kelley located?
Jerri Kelley practices at 30 S 4th St, Newark, OH 43055. The listed phone number is (380) 201-1313.
What is Jerri Kelley's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.
Is Jerri Kelley enrolled in Medicare?
Yes. Jerri Kelley is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jerri Kelley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jerri Kelley reassigns Medicare benefits to Lighthouse Behavioral Health Solutions, LLC (Columbus, OH). 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 Jerri Kelley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jerri Kelley accept?
Health plans from MedMutual, Oscar Health Insurance and Oscar Insurance Corporation of Ohio list Jerri Kelley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jerri Kelley was last updated on March 17, 2024. 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.
# Jerri Kelley · NPI 1871029710
Addiction (Substance Use Disorder) provider in Newark, Ohio. Individual provider, active in the CMS NPPES registry since May 11, 2017.
## Identity
- **NPI:** 1871029710 (Entity type: Individual)
- **Enumerated:** May 11, 2017
- **Primary specialty:** Counselor - Addiction (Substance Use Disorder) · taxonomy 101YA0400X
- **State license:** LICDC.161703 (Ohio)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 30 S 4TH ST, Newark, OH 43055-5002
- **Phone:** (380) 201-1313
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Lighthouse Behavioral Health Solutions, LLC (NPI 1629560230, Columbus, OH), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** March 17, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1871029710) · Data from the CMS NPPES public registry.