Katlin Grace Kellogg, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95020610 Issued in CA

Practice address

2200 Tydd St
Eureka, CA 95501-1284

Phone

(707) 441-1624

NPI assigned

Jul 29, 2022

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Door Community Health CentersGroup PAC ID 9436067485, 113 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus Home Health, Humboldt Home health agency, Eureka, CA, CCN 057256
• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkellogg329053@direct.ochin.org

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.

• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Crescent City, CA
  • NPI 1497840656
  Medicare reassignment Care Compare group NPD
• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • McKinleyville, CA
  • NPI 1598858169
  NPD
• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1831713452
  NPD
• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Arcata, CA
  • NPI 1922318047
  NPD

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

• St. Joseph Health Northern California, LLC

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635
  Care Compare affiliation
• St. Joseph Home Care Network

  • Home Health Agency
  • Eureka, CA
  • NPI 1144315052
  Care Compare affiliation

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1578299665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2969 FICKLE HILL RD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955219064",
            "telephone_number": "707-601-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 TYDD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011284",
            "telephone_number": "707-441-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "KATLIN",
        "middle_name": "GRACE",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95020610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Draven Jay Keller
• Rebecca Jean Keller
• Allison Kelley
• John Christopher Kelley, RN PHN
• Joselyn Kelley, ASW
• Carrie Kelly
• Casey Kelly, PA
• Douglas A Kelly, MD
• Gabrielle Kelly, LCSW
• Hollyn Elizabeth Kelly

• Primary Care Nurse Practitioner in Eureka, CA
• Providers in Eureka, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.