Kevin Kellogg MD PLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

KK073336 Issued in MI

Legal business name

KEVIN KELLOGG MD PLC

Practice address

512 S Bear Lake Rd
North Muskegon, MI 49445-2372

Phone

(231) 563-6580

NPI assigned

Oct 11, 2006

Last updated

May 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christina Liszewski

Title

Office Manager

Phone

(231) 563-6580

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine A Beck

  • Medical Physician Assistant
  • Muskegon, MI
  • NPI 1629002241
  NPD (past)
• Meredith L Best, PAC

  • Physician Assistant
  • Muskegon, MI
  • NPI 1023129517
  NPD (past)
• Jessica L Umlor, PA-C

  • Physician Assistant
  • Portage, MI
  • NPI 1265593685
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1891883146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 S BEAR LAKE RD",
            "city": "NORTH MUSKEGON",
            "state": "MI",
            "postal_code": "494452372",
            "telephone_number": "231-563-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 S BEAR LAKE RD",
            "city": "NORTH MUSKEGON",
            "state": "MI",
            "postal_code": "494452372",
            "telephone_number": "231-563-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN KELLOGG MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "LISZEWSKI",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "231-563-6580"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "KK073336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3510652",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Jane Hardy
• Leslie Hollman, PHARMD
• HPCN (Harbour View Family Medicine)
• Laura Ann Inman, LLPC
• Holly Kendra, ND
• Kevin M Kiley, MD
• Erin Melissa Losee, FNP-C
• Mantych Psychotherapy, LLC (Anne Tyson, LMSW LLC)
• Meijer Inc (Meijer Pharmacy #071)
• Mercy Health

• Specialist in North Muskegon, MI
• Providers in North Muskegon, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.