Amanda L Kellogg, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704287024 Issued in MI

Practice address

3007 N Saginaw Rd
Midland, MI 48640-4555

Phone

(989) 633-1400

Fax

(989) 633-1457

NPI assigned

Oct 11, 2017

Sex

Female

Sole proprietor

No

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akellogg70185@mymichiganhealth.midirect.net

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.

• Mymichigan Medical Group

  • Family Medicine Physician
  • Midland, MI
  • NPI 1740230127
  Medicare reassignment NPD
• Mymichigan Medical Center Alpena

  dba MyMichigan Family Medicine

  • Rural Health Clinic/Center
  • Alpena, MI
  • NPI 1144722604
  NPD
• Mymichigan Medical Group

  • Internal Medicine Physician
  • Midland, MI
  • NPI 1629027669
  NPD (past)

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1144730581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 N SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404555",
            "telephone_number": "989-633-1400",
            "fax_number": "989-633-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 N SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404555",
            "telephone_number": "989-633-1400",
            "fax_number": "989-633-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704287024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jyl Kirsten Keinath
• Jennifer Keister, LMSW
• Caitlyn Kelenske
• Libbee Jo Kelingos, LLPC
• Shannon Kellenberger
• Michelle Ann Kennedy
• Tina M Kennedy, M.B.A. R.D.
• Matthew P Kenny, PA-C
• Kent R. Biddinger, M.D.
• Abigail Elaine Kerkau

• Nurse Practitioner in Midland, MI
• Providers in Midland, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.

Verify at the official NPI Registry.