Individual provider Active NPI

Mary Edith Kellogg, FNP-C

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1871380600
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906825 Issued in MS
Practice address
2124 14TH St
Meridian, MS 39301-4040
Phone
(601) 553-6000
NPI assigned
Apr 23, 2025
Last updated
May 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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 906825 MS Primary

Addresses

Primary practice location

2124 14TH St
Meridian, MS 39301-4040

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (901) 226-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20250626004248 MS Practitioner - Nurse Practitioner 3274046917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Physician Alliance IncGroup PAC ID 3274727318, 69 clinicians

Practice addresses (Care Compare)

2111 14TH St
Meridian, MS 39301-4041
Phone (601) 693-3834

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Physician Alliance, Inc. CurrentSince May 27, 2025 Accepting new patients
Urology Clinic of Meridian, P.a. Current Accepting new patients

Locations

1600 22nd Ave
Meridian, MS 39301
Phone (601) 483-5322

2111 14th St
Meridian, MS 39301
Phone (601) 693-3834

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

Interoperability endpoints

  • Direct secure messaging: mkellogg681285@direct.bmhcc.org

Organizations & group practices 2

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 1

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": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1871380600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "901-226-4003",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014040",
            "telephone_number": "601-553-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "MARY",
        "middle_name": "EDITH",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.