Fredric Russell Kellogg, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125401 Issued in NY

Practice address

222 W 14TH St
New York, NY 10011-7200

Phone

(212) 604-1800

Fax

(212) 604-1892

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1053341735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W 13TH ST",
            "address_2": "#2C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117912",
            "telephone_number": "212-604-8026",
            "fax_number": "212-604-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117200",
            "telephone_number": "212-604-1800",
            "fax_number": "212-604-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "FREDRIC",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "125401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00520383",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Paul Kellner, M.D.
• Curtis Jay Kellner, RPH
• Jack Kellner, M.D.
• Judith Kellner, LCSW
• Ethan Kellogg, M.D.
• Margaret S Kellogg, LMT
• Scott Kellogg, PHD
• Tara J Kellogg, B.S., D.C.
• Latimer Kells, M.S., CCC-SLP
• Shaquana Kellum, PEER SPECIALIST

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.