Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edward Leslie Kelly, MD

Individual provider Forensic Psychiatry Physician · NPI 1013995471

Edward Leslie Kelly, MD is a Psychiatry in Provo, Utah. Qualified in 1992, 34 years ago. Practices with State of Utah, a 31-clinician group and accepts Medicare assignment. Licensed in Minnesota, Nebraska, Utah and Washington.

Years since qualifying
34
Licensed in
MN, NE, UT, WA
In the registry since
2006
Specialties on file
8
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1300 E Center St
Provo, UT 84606-3554
Phone: (801) 344-4400
Fax: (801) 344-4225
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Forensic Psychiatry Physician (primary) Taxonomy 2084F0202X · Licence 10382404-1205 (UT)
Forensic Psychiatry Physician Taxonomy 2084F0202X · Licence 26951 (NE)
Forensic Psychiatry Physician Taxonomy 2084F0202X · Licence 42929 (MN)
Forensic Psychiatry Physician Taxonomy 2084F0202X · Licence MD00040860 (WA)
Psychiatry Physician Taxonomy 2084P0800X · Licence 26951 (NE)
Psychiatry Physician Taxonomy 2084P0800X · Licence MD00040860 (WA)
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X · Licence MD00040860 (WA)
Geriatric Psychiatry Physician Taxonomy 2084P0805X · Licence MD00040860 (WA)

Record details

NPI number1013995471
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 5, 2006
Last updated in NPPESMarch 24, 2025
Certification dateMarch 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice State Of Utah — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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