Clint W Kellogg, D.O.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

2018010581 Issued in MO

Practice address

3600 Amron CT
Columbia, MO 65202

Phone

(573) 874-1616

Fax

(573) 875-0300

NPI assigned

Apr 30, 2013

Last updated

Mar 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina Associates of Missouri PCGroup PAC ID 6507924263, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boone Hospital Center Hospital, Columbia, MO, CCN 260068

Merit-based Incentive Payment System (MIPS)

Final score

98.72 of 100Reported as group

Quality

97.43

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckellogg@retinamo.intellechartdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Retina Associates of Missouri, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Columbia, MO
  • NPI 1144204553

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Columbia Orthopaedic Group, LLP

  • Orthopaedic Surgery Physician
  • Columbia, MO
  • NPI 1851392542

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CH Allied Services, Inc

  dba Boone Hospital Center

  • Cardiac Rehabilitation Clinic/Center
  • Columbia, MO
  • NPI 1548734734

  Hospital

  Care Compare affiliation
• CH Allied Services, Inc.

  dba Boone Hospital Center

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1902817844
  Care Compare affiliation

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1477998839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 AMRON CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652021918",
            "telephone_number": "573-874-1616",
            "fax_number": "573-875-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 AMRON CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65202",
            "telephone_number": "573-874-1616",
            "fax_number": "573-875-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7031 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "South Miami",
            "state": "FL",
            "postal_code": "331434701",
            "country_code": "US",
            "telephone_number": "305-284-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "CLINT",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "Q9396",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MO",
            "license": "2018010581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckellogg@retinamo.intellechartdirect.net",
            "affiliation": "N",
            "endpointDescription": "Clint W. Kellogg, D.O.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3600 Amron Ct",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652021918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Olivia Keller-Baruch
• Morgan Keller
• Darlene Kelley
• Jordan M Kelley, LMT
• Morgan Kelley
• Glenda Kaye Kellogg, LCSW
• Danielle Ariana Kelly, RBT
• Dedrae Kelly, PLPC
• Jennifer Lynne Kelly, AGNP
• Kristina Marie Kelly, DPT

• Retina Specialist (Ophthalmology) Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Retina Specialist (Ophthalmology) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.