Active NPI
Kelly N Vogt, M.D., FRCSC
- Surgery Physician
- Los Angeles, CA
National Provider Identifier
1710232103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- A122201
- Practice address
- 1500 San Pablo St
Los Angeles, CA 90033-5313 - Phone
- (323) 442-5907
- NPI assigned
- Jul 21, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A122201 | CA | Primary |
| Trauma Surgery Physician | 2086S0127X | A122201 | CA |
Addresses
Primary practice location
1500 San Pablo St
Los Angeles, CA 90033-5313
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-4123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A122201 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385078400000",
"number": "1710232103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "626-457-4123",
"fax_number": "626-457-4125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 SAN PABLO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335313",
"telephone_number": "323-442-5907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOGT",
"first_name": "KELLY",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "M.D., FRCSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-21",
"last_updated": "2013-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A122201",
"primary": true
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "CA",
"license": "A122201",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.