Individual provider Active NPI

Kathryn Nicole Logan, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1003437880
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-134637 Issued in AL
Practice address
4371 Narrow Lane Rd Ste 205
Montgomery, AL 36116-2975
Phone
(334) 747-7780
Fax
(334) 747-7790
NPI assigned
May 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-134637 AL Primary

Addresses

Primary practice location

4371 Narrow Lane Rd Ste 205
Montgomery, AL 36116-2975

Mailing address

301 Brown Springs Rd
Montgomery, AL 36117-7005
Phone (334) 747-4159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220303001242 AL Practitioner - Nurse Practitioner 2860886090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4371 Narrow Lane Rd
Suite 205
Montgomery, AL 36116-2975
Phone (334) 747-7780

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
64.43
Promoting interoperability
100
Improvement activities
40
Cost
78.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-134637ALMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Dec 1, 2021 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Dec 1, 2021 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients

Locations

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

4371 Narrow Lane Rd
Ste 205
Montgomery, AL 36116
Phone (334) 323-3307

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1003437880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROWN SPRINGS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177005",
            "telephone_number": "334-747-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 NARROW LANE RD STE 205",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162975",
            "telephone_number": "334-747-7780",
            "fax_number": "334-747-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "KATHRYN",
        "middle_name": "NICOLE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-02",
        "last_updated": "2023-01-11",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-134637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.