Jeffrey L. Kellogg, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02201 Issued in IA

Practice address

4545 Sergeant Rd
Sioux City, IA 51106-4706

Phone

(712) 274-2400

Fax

(712) 274-1484

NPI assigned

Jun 14, 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Health Care of Siouxland LLC

  dba Family Health Care Moville Clinic

  • Family Medicine Physician
  • Moville, IA
  • NPI 1720278278
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1083657084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 PIERCE ST",
            "address_2": "STE102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011061",
            "telephone_number": "712-226-2600",
            "fax_number": "712-226-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 SERGEANT RD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064706",
            "telephone_number": "712-274-2400",
            "fax_number": "712-274-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "JEFFREY",
        "middle_name": "L.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "02201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1098830",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7764992",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK OF IA",
            "identifier": "70220",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex G Kazos, M.D.
• Nicole Anne Keegan, CADC
• Christopher John Keller, RPH
• Megdalin Rose Keller
• Marty J Kelley, DPM
• Kornelia Kellogg, D.O.
• Amanda Lynne Kelly
• Steven Alan Kelsey, DPT
• Kirk D Kempter, CRNA
• Carl Kendrick, DMD

• Family Medicine Physician in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.