CLINT W KELLOGG (NPI# 1477998839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477998839 |
| Entity Type | Individual |
| Full Name | CLINT W KELLOGG |
| Credential | D.O. |
| Practice Address |
3600 Amron Ct Columbia MO 65202 |
| Mailing Address |
3600 Amron Ct Columbia MO 65202-1918 |
| Practice Telephone | 5738741616 |
| Practice Fax Number | 5738750300 |
| Mailing Telephone | 5738741616 |
| Mailing Fax Number | 5738750300 |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2018-08-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | Q9396 | TX | Allopathic & Osteopathic Physicians |
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
2018010581 | MO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7031 Sw 62nd Ave, South Miami, FL 331434701 | 3052847500 |
| Street Address |
3600 AMRON CT |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902880313 | Mari Ann Keithahn | Ophthalmology | 3600 Amron Ct, Columbia, MO 65202-1918 | 2005-11-30 |
| 1265663017 | Wayne Earl Davis | Ophthalmology | 3600 Amron Ct, Columbia, MO 65202-1918 | 2009-07-28 |
| 1790769701 | Jerry R Blair | Ophthalmology | 3600 Amron Ct, Columbia, MO 65202-1918 | 2005-12-02 |
| 1144204553 | Retina Associates of Missouri, P.C. | Ophthalmology | 3600 Amron Ct, Columbia, MO 65202-1918 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374629 | Curators of The University of Missouri | Pharmacy | 7115 East St. Charles Road, Columbia, MO 65202 | 2020-10-21 |
| 1245871540 | Ranshell Micole Harrington | Registered Nurse | 7455 Noah Court Columbia, Mo65202, Columbia, MO 65202 | 2019-10-08 |
| 1326514381 | Clark Supported Living | Registered Nurse | 303 Macaw Dr, Columbia, MO 65202 | 2018-10-17 |
| 1851873608 | Phoenix Programs, Inc. | Counselor | 90 E. Leslie Ln., Columbia, MO 65202 | 2018-08-29 |
| 1760973044 | Centerpointe Hospital of Columbia, LLC | Psychiatric Hospital | 1201 International Drive, Columbia, MO 65202 | 2018-05-23 |
| 1710409198 | Lena-frances Sheets | Counselor | 3509 Deer Run Drive, Columbia, MO 65202 | 2017-07-07 |
| 1235669037 | Henry William Clark | Counselor | 409 Vandiver West Bldg 6, Suite 102a, Great Circle, Columbia, MO 65202 | 2017-06-14 |
| 1083065148 | Waleed Raheem Abood Abood | Psychiatry & Neurology | 1 Hospital Drive, Ste 507, Columbia, MO 65202 | 2016-06-29 |
| 1871993923 | Li Ma | Physician Assistant | 1909 Mayberry Drive, Columbia, MO 65202 | 2014-08-26 |
| 1134543614 | Meghan Lees | Nurse Anesthetist, Certified Registered | 4608 Waterloo Driv, Ste 170, Columbia, MO 65202 | 2014-02-05 |
| Find all providers in zip 65202 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971620 | Missouri Retina Consultants PC | Ophthalmology | 105 N Keene St Ste 102, Columbia, MO 65201-8131 | 2020-10-29 |
| 1457301996 | William Fort Crosswell | Ophthalmology | 1920 Pickens St, Columbia, SC 29201 | 2006-05-12 |
| 1982662847 | Derek L Barker | Ophthalmology | 1920 Pickens St, Columbia, SC 29201-2632 | 2006-05-02 |
| 1144204553 | Retina Associates of Missouri, P.C. | Ophthalmology | 3600 Amron Ct, Columbia, MO 65202-1918 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476560 | Kevin J Blinder | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-06-08 |
| 1427439298 | Bliss Elizabeth O'bryhim | Ophthalmology | 517 S Euclid Ave, Saint Louis, MO 63110-1007 | 2015-06-17 |
| 1700175395 | Retina Consultants, Ltd | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2011-04-04 |
| 1073778460 | Clayton Greer Scanlon | Ophthalmology | 1224 Graham Rd, 3011, Florissant, MO 63031-8028 | 2008-07-24 |
| 1750581666 | Retina Associates of St Louis, Inc | Ophthalmology | 1224 Graham Rd, Suite 3011, Florissant, MO 63031-8028 | 2007-07-19 |
| 1003019019 | Blonie Wayne Dudney Jr. | Ophthalmology | 1224 Graham Rd, 3011, Florissant, MO 63031-8028 | 2007-06-07 |
| 1891807137 | David A. Glaser | Ophthalmology | 1224 Graham Rd, Suite 3011, Florissant, MO 63031-8028 | 2006-08-31 |
| 1851403190 | Carla Territo | Ophthalmology | 1224 Graham Rd, Suite 3011, Florissant, MO 63031-8028 | 2006-08-31 |
| 1588608970 | Bradley Thomas Smith | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2006-06-15 |
| 1205837978 | Thomas K Krummenacher | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-08-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.