Active NPI
Lisa Marie Aanonsen Kellogg, PT, DPT
- Physical Therapist
- Basalt, CO
National Provider Identifier
1275727950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7897
- Practice address
- 374 Sopris Cir
Basalt, CO 81621-8373 - Phone
- (970) 456-3612
- NPI assigned
- Sep 5, 2007
- Last updated
- Aug 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7897 | CO | Primary |
Addresses
Primary practice location
374 Sopris Cir
Basalt, CO 81621-8373
Mailing address
PO Box 589
Basalt, CO 81621-0589
Phone (970) 456-3612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1275727950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 589",
"city": "BASALT",
"state": "CO",
"postal_code": "816210589",
"telephone_number": "970-456-3612",
"fax_number": "970-312-8032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 SOPRIS CIR",
"city": "BASALT",
"state": "CO",
"postal_code": "816218373",
"telephone_number": "970-456-3612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AANONSEN KELLOGG",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-05",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "7897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Basalt, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.