KELLY S EARNST PH.D HSPP NPI 1104900489

NPI Information

  • NPI: 1104900489
  • Provider Name: KELLY S EARNST, PH.D, HSPP
  • Classification: Clinical Neuropsychologist - 103G00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1415 SALEM ST
    SUITE 102
    LAFAYETTE, IN
    ZIP 47904
  • Phone: (765) 742-1816

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NPI Details

Kelly S Earnst, PH.D, HSPP is a clinical neuropsychologist in Lafayette, IN with 28 years of experience. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Kelly S Earnst, PH.D, HSPP NPI is 1104900489. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1998

The provider's business location address is:

1415 SALEM ST
SUITE 102
LAFAYETTE, IN
ZIP 47904-100
Phone: (765) 742-1816
Fax: (765) 742-2557

The NPI 1104900489 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of psychological or neuropsychological test by technician, each additional 30 minutes (HCPCS:96139)
  • Evaluation of neuropsychological test, each additional hour (HCPCS:96133)
  • Psychiatric diagnostic evaluation (HCPCS:90791)
  • Evaluation of neuropsychological test, first hour (HCPCS:96132)
  • Administration of psychological or neuropsychological test by technician, first 30 minutes (HCPCS:96138)

The enumeration date for this NPI number is 10/24/2006 and was last updated on 6/27/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical Neuropsychologist20041614AYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200283610AMEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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