Carolyn Jo Kellogg, ARNP BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30000016 Issued in WA

Practice address

2601 Cherry Ave
#213
Bremerton, WA 98310-4203

Phone

(360) 479-6041

Fax

(360) 405-0768

NPI assigned

Apr 17, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Donald L Sharman MD Inc PS

  • Internal Medicine Physician
  • Bremerton, WA
  • NPI 1881634251
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1326264631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 CHERRY AVE",
            "address_2": "#213",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104203",
            "telephone_number": "360-479-6041",
            "fax_number": "360-405-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 CHERRY AVE",
            "address_2": "#213",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104203",
            "telephone_number": "360-479-6041",
            "fax_number": "360-405-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "CAROLYN",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "ARNP BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30000016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9652801",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Pearl Keeling, SUDP-T
• William C Kehl
• Kristi Keller
• Thomas Ryan Keller
• Randall Grant Kelley, D.O.
• Bret M Kelly
• John Kelly
• Jonathon Luther Kelly, IDC
• Sandra L Kelly, RDH
• Tracy Kendrick

• Family Nurse Practitioner in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.