Michael F Kellogg, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

024875 Issued in CT

Practice address

1064 E Main St
Suite 301
Meriden, CT 06450-4898

Phone

(203) 634-3636

Fax

(203) 634-1972

NPI assigned

Jul 19, 2005

Sex

Male

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

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: michael.kellogg.1@5084.direct.athenahealth.com

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1437158672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 E MAIN ST",
            "address_2": "SUITE 301",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504898",
            "telephone_number": "203-634-3636",
            "fax_number": "203-634-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 E MAIN ST",
            "address_2": "SUITE 301",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504898",
            "telephone_number": "203-634-3636",
            "fax_number": "203-634-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "024875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012487568",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellie Katkauskas, MFT-A
• Janice A Keeman, LCSW
• Eileen Kehoe, M.D.
• Sara Keiling, A.P.R.N. BC
• Sean Keiran
• Kimberly Kelly, LCSW
• Malik J Kelly, MD
• Peter James Kelly, CRNA
• Simone V Kennedy, PA-C
• Thomas Martin Kennedy, M.D.

• Family Medicine Physician in Meriden, CT
• Providers in Meriden, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.