Individual provider Active NPI

Lisa S Kellogg, D.O.

  • Family Medicine Physician
  • Gallatin, TN
National Provider Identifier
1720034127
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1755 Issued in TN
Practice address
1531 Hunt Club Blvd Ste 100
Gallatin, TN 37066-6096
Phone
(615) 431-9930
Fax
(615) 431-9940
NPI assigned
May 26, 2006
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1755 TN Primary

Addresses

Primary practice location

1531 Hunt Club Blvd Ste 100
Gallatin, TN 37066-6096

Mailing address

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 239-2018

Other identifiers 3

IdentifierTypeStateIssuer
33000031OtherTNMEDICARE TAX ID 201119913
33000032MedicaidTN
P00419528OtherRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LISA.KELLOGG@hca1.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20070412000147 TN Practitioner - Family Practice 5698870145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Homeopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Diagnostic Imaging PCGroup PAC ID 7315848140, 523 clinicians

Practice addresses (Care Compare)

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 851-6033

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions80
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC CurrentSince Sep 26, 2021 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Sep 26, 2021 Accepting new patients
Portland Primary Care, LLC Family Medicine Past Accepting new patients

Locations

1531 Hunt Club Blvd
Ste 100
Gallatin, TN 37066
Phone (615) 230-1600

3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018

355 New Shackle Island Rd
Hendersonvlle, TN 37075
Phone (615) 264-4000

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

491 Sage Rd N
Ste 200
White House, TN 37188
Phone (615) 581-5925

Interoperability endpoints

  • Direct secure messaging: lisa.kellogg@ahp.eclinicaldirectplus.com
  • Direct secure messaging: lisa.kellogg@hca1.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1720034127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-239-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 HUNT CLUB BLVD STE 100",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370666096",
            "telephone_number": "615-431-9930",
            "fax_number": "615-431-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "LISA",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TAX ID 201119913",
            "identifier": "33000031",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33000032",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00419528",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LISA.KELLOGG@hca1.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "103 Redbud Dr",
            "address_2": "SUITE E",
            "city": "Portland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371481617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.