NPIMap

Individual provider Active NPI

Logan Bode Howard, PA

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1003579889
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2728 Issued in NV
Practice address
10635 Professional Cir Ste a
Reno, NV 89521-5836
Phone
(775) 852-0505
Fax
(775) 852-0508
NPI assigned
Oct 18, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2728 NV Primary

Addresses

Primary practice location

10635 Professional Cir Ste a
Reno, NV 89521-5836

Mailing address

10635 Professional Cir Ste a
Reno, NV 89521-5836
Phone (775) 852-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230103001908 NV Practitioner - Physician Assistant 0840660171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nevada OrthopedicsGroup PAC ID 6901959139, 2 clinicians
Custom Physical Therapy Limited PartnershipGroup PAC ID 1355252842, shared by 2 NPIs, 76 clinicians

Practice addresses (Care Compare)

10635 Professional Cir
Suite a
Reno, NV 89521-5836
Phone (775) 852-0505

10635 Professional Cir a
Reno, NV 89521-5836

440 E Golden Valley Rd
Suite Aandb
Reno, NV 89506-5722
Phone (775) 360-3000

Hospital & facility affiliations

  • Northern Nevada Medical Center Hospital, Sparks, NV, CCN 290032
  • Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049
  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Pershing General Hospital Hospital, Lovelock, NV, CCN 291304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: logan.howard.1@29001.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1003579889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10635 PROFESSIONAL CIR STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215836",
            "telephone_number": "775-852-0505",
            "fax_number": "775-852-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10635 PROFESSIONAL CIR STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215836",
            "telephone_number": "775-852-0505",
            "fax_number": "775-852-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "LOGAN",
        "middle_name": "BODE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.