Active NPI
Sally Stephens Logan, R.D.
- Registered Dietitian
- Virginia Beach, VA
National Provider Identifier
1023298650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 1732 Buckley Arch
Virginia Beach, VA 23453-7081 - Phone
- (757) 430-8256
- NPI assigned
- Nov 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
1732 Buckley Arch
Virginia Beach, VA 23453-7081
Mailing address
1732 Buckley Arch
Virginia Beach, VA 23453-7081
Phone (757) 430-8256
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 448386 | Other | REGISTRATION NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194825600000",
"number": "1023298650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1732 BUCKLEY ARCH",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234537081",
"telephone_number": "757-430-8256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1732 BUCKLEY ARCH",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234537081",
"telephone_number": "757-430-8256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "SALLY",
"middle_name": "STEPHENS",
"name_prefix": "Mrs.",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-12",
"last_updated": "2007-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTRATION NUMBER",
"identifier": "448386",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.