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

Kelly Lane Blair, PHD

Individual provider Clinical Psychologist · NPI 1891711131

Kelly Lane Blair, PHD is a Clinical Psychologist in Jackson, Tennessee. Qualified in 1993, 33 years ago. Practices with West Tennessee Medical Group Inc, a 190-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
33
Licensed in
TN
In the registry since
2006
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

708 W Forest Ave
Jackson, TN 38301-3901
Phone: (731) 425-4930
Show map & directions

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

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 1706 (TN)
Rehabilitation Psychologist Taxonomy 103TR0400X · Licence 1706 (TN)

Record details

NPI number1891711131
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJuly 13, 2006
Last updated in NPPESJuly 31, 2009

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice West Tennessee Medical Group Inc — 190 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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