Active NPI
Pamela Parkinson Kellogg, MD
- Psychiatry Physician
- Brookline, MA
National Provider Identifier
1114088150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 50661
- Practice address
- 101 Ivy St
Brookline, MA 02446-4004 - Phone
- (617) 566-7428
- Fax
- (617) 232-3967
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 50661 | MA | Primary |
Addresses
Primary practice location
101 Ivy St
Brookline, MA 02446-4004
Mailing address
101 Ivy St
Brookline, MA 02446-4004
Phone (617) 566-7428
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700820 | Other | MA | TUFTS HEALTH PLAN |
| M17784 | Other | MA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50661 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114088150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 IVY ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464004",
"telephone_number": "617-566-7428",
"fax_number": "617-232-3967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 IVY ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464004",
"telephone_number": "617-566-7428",
"fax_number": "617-232-3967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLOGG",
"first_name": "PAMELA",
"middle_name": "PARKINSON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "50661",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "700820",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "M17784",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.