Logan Stephen Bannon

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1107 NE 45TH St Ste 100
Seattle, WA 98105-4631

Phone

(206) 545-7844

NPI assigned

Apr 2, 2021

Last updated

Apr 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

520 Physical Therapy, LLCGroup PAC ID 2062816168, 7 clinicians

Hidef Seattle,LLCGroup PAC ID 1850775917, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• 520 Physical Therapy, LLC

  dba HIDEF Physical Therapy

  • Physical Therapy Clinic/Center
  • Bellevue, WA
  • NPI 1740864982

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Hidef Seattle,LLC

  dba HIDEF Seattle Sports & Physical Therapy

  • Physical Therapy Clinic/Center
  • Maple Valley, WA
  • NPI 1841814027
  Medicare reassignment Care Compare group NPD
• Apple Physical Therapy, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Auburn, WA
  • NPI 1902808470
  Medicare reassignment NPD
• Tuohy Physical Therapy LLC

  dba Advantage Physical therapy and sports rehabilitation

  • Physical Therapy Clinic/Center
  • Redmond, WA
  • NPI 1336471143
  Medicare reassignment NPD
• Apple Physical Therapy LLC

  dba ATI Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • Mountlake Terrace, WA
  • NPI 1366746232

  Physical Therapist

  NPD

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1003494618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 NE 45TH ST STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054631",
            "telephone_number": "206-545-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNON",
        "first_name": "LOGAN",
        "middle_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Banks
• Maralyssa Angelique Bann, M.D.
• Lael B Banner, DDS
• Kelly Bannister
• Laura Bannister, DPT
• Esther Bannwart, LMP
• Gaurav Kumar Bansal, D.O.
• Hitashi Bansal
• Manju Bala Bansal
• Nisha Bansal, M.D.

• Physical Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.