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DR. KENNETH W KELLOUGH M.D.
NPI 1609815000
Internal Medicine in Clarksdale, MS

Active since June 04, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
705 N STATE ST, CLARKSDALE, MS 38614(662) 621-2192(662) 621-2314 Get Directions Write a Review

NPPES record last updated: December 3, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kenneth W Kellough M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH W KELLOUGH M.D. (NPI 1609815000) is an individual internal medicine provider in Clarksdale, Mississippi, licensed in Mississippi (16776) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Bolivar Medical Center, and is a graduate of University Of Texas Medical Branch At Galveston (1996).

NPPES Registry Identity

NPI1609815000
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. KENNETH W KELLOUGHCredential: M.D.
Location Address705 N STATE STClarksdale, MS 38614-6519
Mailing Address705 N State StClarksdale, MS 38614-6519 · (662) 621-2192 · Fax (662) 621-2314
Phone(662) 621-2192
Fax(662) 621-2314
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 1996
Enumeration DateJune 4, 2006
Last NPPES UpdateDecember 3, 2009
✔ NPI 1609815000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MS · 16776
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
705 N STATE ST, Clarksdale, MS 38614
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Other Identifiers 3

Medicare UPING95515
Medicare PIN110001771MS
Medicaid00121009MS

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kenneth W Kellough M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769379650
PECOS Enrollment IDI20040304000139
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
514 services413 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
414 services335 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
86 services75 patients
Emergency department visit with straightforward medical decision making 99282
An emergency department visit for a mild to moderate issue is when you seek immediate medical attention for a non-life-threatening condition. This could include minor injuries, moderate pain, or illnesses like the flu. During the visit, healthcare professionals assess your condition, provide treatment, and may recommend follow-up care.
15 services15 patients
Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm 12002
This is a procedure to mend a surface wound measuring between 2.6-7.5 cm on your scalp, neck, underarms, trunk, arms, or legs. It involves cleaning, closing and dressing the wound to promote healing and prevent infection.
12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bolivar Medical Center

Acute Care Hospitals · Cleveland, MS
3/5 CMS rating
OwnershipProprietary
CMS Certification Number250093
Location901 E Sunflower RdCleveland, MS 38732 · Bolivar County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$120.41 typical visit price
range $51.65 – $159.18
Typical copayment $30.10 (range $12.91 – $39.79)
Most-billed visit code 99204
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality95.72
Improvement Activities40
Cost81.58

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Lower rates are better for this measure.
10%20 patients4/55-star benchmark: 100%
Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis
91%58 patients
Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 18 Years and Older
71%24 patients
Ultrasound Determination of Pregnancy Location for Pregnant Patients with Abdominal Pain
95%22 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DELTA CONCIERGE MEDICINE, INC.
Health Maintenance Organization
705 N STATE ST
CLARKSDALE, MS 38614
Coahoma County (662) 621-2192
NORTH DELTA MEDICINE CLINIC P A
Internal Medicine
705 N STATE ST
CLARKSDALE, MS 38614
Coahoma County (662) 621-2192
KAYLEA BYRD MCCRAW
Nurse Practitioner (Family)
705 N STATE ST
CLARKSDALE, MS 38614
Coahoma County (662) 627-2973
BYRD FAMILY MEDICAL CLINIC
Clinic/Center (Primary Care)
705 N STATE ST
CLARKSDALE, MS 38614
Coahoma County (662) 627-2973

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Kellough's NPI number?

The NPI number for Kenneth Kellough is 1609815000. It was assigned to this individual provider in the NPPES registry on June 4, 2006.

Where is Kenneth Kellough located?

Kenneth Kellough practices at 705 N State St, Clarksdale, MS 38614. The listed phone number is (662) 621-2192.

What is Kenneth Kellough's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kenneth Kellough enrolled in Medicare?

Yes. Kenneth Kellough is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kenneth Kellough affiliated with any hospitals?

According to CMS data, Kenneth Kellough is affiliated with Bolivar Medical Center.

When was this NPI record last updated?

The NPPES record for Kenneth Kellough was last updated on December 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.