Individual provider Active NPI

Teresa Lynn Kellogg, RN, MSN, NP-C, FNP

  • Family Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1801198130
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
129066 Issued in MO
Practice address
6938 Elm Valley Dr
Kalamazoo, MI 49009-7447
Phone
(269) 552-4233
Fax
(269) 552-4216
NPI assigned
Nov 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 129066 MO Primary

Addresses

Primary practice location

6938 Elm Valley Dr
Kalamazoo, MI 49009-7447

Mailing address

6938 Elm Valley Dr
Kalamazoo, MI 49009-7447
Phone (269) 552-4233

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20141006000417 MI Practitioner - Nurse Practitioner 0941489512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

6938 Elm Valley Dr
101 Bronson Family Medicine the Groves
Kalamazoo, MI 49009-7447
Phone (269) 552-4233

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Bronson South Haven Hospital Hospital, South Haven, MI, CCN 230085
  • Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
129066MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Dec 1, 2015 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

6938 Elm Valley Dr
Ste 101
Kalamazoo, MI 49009
Phone (269) 552-4167

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

6938 Elm Valley Dr
Kalamazoo, MI 49009
Phone (269) 341-7272

3300 W Centre Ave
Portage, MI 49024
Phone (269) 324-8950

Interoperability endpoints

  • Direct secure messaging: tkellogg41086@direct.bronsonhg.org
  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1801198130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6938 ELM VALLEY DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490097447",
            "telephone_number": "269-552-4233",
            "fax_number": "269-552-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6938 ELM VALLEY DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490097447",
            "telephone_number": "269-552-4233",
            "fax_number": "269-552-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, NP-C, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "129066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.