Mariah A. Kellogg, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH11653 Issued in AL

Practice address

1324 Ross Clark Cir
Dothan, AL 36301-4117

Phone

(334) 769-2003

Fax

(334) 769-2004

NPI assigned

Jun 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mariah A Cairer Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Borealis Chiropractic Inc

  • Chiropractor
  • Soldotna, AK
  • NPI 1558800607
  NPD

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1629694112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014117",
            "telephone_number": "334-769-2003",
            "fax_number": "334-769-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014117",
            "telephone_number": "334-769-2003",
            "fax_number": "334-769-2004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35249 Kenai Spur Hwy",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697673",
            "country_code": "US",
            "telephone_number": "907-420-0836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "MARIAH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH11653",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "162927",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcairer@revolutionak.com",
            "affiliation": "N",
            "address_1": "35249 Kenai Spur Hwy",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIAH",
            "last_name": "CAIRER",
            "middle_name": "A",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelcey L Williams MD PLLC
• Kelcey L. Williams, MD, PLLC
• Mitzi Deanna Kellett, RBT
• Allan Jeffrey Kelley, MD
• Lela Smith Kelley, PHARMD
• Carrie Hanna Kelly, R.N.
• Jane C Kelly, CRNA
• Lindsay Kelly, PHARMD
• Arthur C Kendig, MD
• Bryan T Kendricks, D.M.D., M.D.

• Physical Therapist in Dothan, AL
• Providers in Dothan, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.