Active NPI
Collyn Michael Kellogg
- Internal Medicine Physician
- Oklahoma City, OK
National Provider Identifier
1255920690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 48226
- Practice address
- 800 Stanton L Young Blvd
Oklahoma City, OK 73104-5018 - Phone
- (405) 271-5963
- NPI assigned
- Jan 11, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 48226 | OK | Primary |
Addresses
Primary practice location
800 Stanton L Young Blvd
Oklahoma City, OK 73104-5018
Mailing address
17604 Horne LN
Edmond, OK 73012-4606
Phone (713) 213-8060
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48226 | OK | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779235200000",
"number": "1255920690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17604 HORNE LN",
"city": "EDMOND",
"state": "OK",
"postal_code": "730124606",
"telephone_number": "713-213-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 STANTON L YOUNG BLVD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045018",
"telephone_number": "405-271-5963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLOGG",
"first_name": "COLLYN",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-11",
"last_updated": "2026-05-20",
"certification_date": "2026-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OK",
"license": "48226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.