Active NPI
Logan N Sullivan, RD LDN
- Registered Dietitian
- Canfield, OH
National Provider Identifier
1013688423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 08986
- Practice address
- 8820 S Raccoon Rd
Canfield, OH 44406-8171 - Phone
- (330) 727-0175
- NPI assigned
- Sep 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 08986 | OH | Primary |
Addresses
Primary practice location
8820 S Raccoon Rd
Canfield, OH 44406-8171
Mailing address
8820 S Raccoon Rd
Canfield, OH 44406-8171
Phone (330) 727-0175
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | CANFIELD | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08986 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LS Nutrition, LLC | Dietitian, Registered | Current | Accepting new patients |
| Building Better Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632441600000",
"number": "1013688423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8820 S RACCOON RD",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444068171",
"telephone_number": "330-727-0175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8820 S RACCOON RD",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444068171",
"telephone_number": "330-727-0175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "LOGAN",
"middle_name": "N",
"name_prefix": "Miss",
"credential": "RD LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-24",
"last_updated": "2021-09-24",
"certification_date": "2021-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "08986",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "CANFIELD",
"affiliation": "N",
"endpointDescription": "EMR Healthie",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Healthie",
"address_1": "8820 S Raccoon Rd",
"city": "Canfield",
"state": "OH",
"country_code": "US",
"postal_code": "444068171",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Canfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.