NPIMap

Logan Physician Practice LLC

A Medicare group practice based in Russellville, KY: 4 NPIs enrolled under one PECOS associate control ID (PAC ID 4880596592), with 17 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
4880596592The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Clinic/Group Practice
Enrolled in
KY
Enrollments
1
Group size
6 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
5In 3 places

Enrollment records 1

Enrollment IDStateProvider typeNPI
O20040219000212 KY Part B Supplier - Clinic/Group Practice 1265740765

NPIs in this group 4

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 17

Clinicians who reassign their Medicare benefits to this group (14) or whom Care Compare lists as members (6).

Sources for this page