Vernon Kellog, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

38932 Issued in MA

Practice address

242 Green St
Gardner, MA 01440-1336

Phone

(978) 632-3420

Fax

(978) 630-6596

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144341470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-632-3420",
            "fax_number": "978-630-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-632-3420",
            "fax_number": "978-630-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOG",
        "first_name": "VERNON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "38932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Cynthia Kairouz
• Kalyan Kalava, M.D.
• Richard E Keelan, MA
• Hannah Keesee
• Shelly Kelley
• Nicholas J Killick, LMHC
• Beyang Kima-Tabong, RPH
• Matthew Sposito Kincaid
• Antonina Salvatrice Klauzinski, FNP
• Kelly Marie Knapp

• Emergency Medicine Physician in Gardner, MA
• Providers in Gardner, MA by specialty
• Emergency Medicine Physician in Massachusetts

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.