Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Clark Kellogg

Individual provider Anesthesiologist Assistant · NPI 1457098154

Clark Kellogg is an Anesthesiology Assistant in Mansfield, Ohio. Qualified in 2022, 4 years ago. Practices with Anesthesia Associates of Mansfield, Inc, a 27-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2022

Practice location Address checks out

799 Lexington Ave
Mansfield, OH 44907-1906
Phone: (419) 756-5133
Fax: (419) 774-9707
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence 32698321 (OH)

Record details

NPI number1457098154
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 16, 2022
Last updated in NPPESJanuary 9, 2023
Certification dateJanuary 9, 2023
Mailing address5910 Bluestone Way, Lewis Center, OH 43035-7550

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Anesthesia Associates Of Mansfield, Inc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mansfield