Individual provider Active NPI

Logan Marie Justice

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1023942836
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2026025437 Issued in MO
Practice address
4045 Shaw Blvd FL 1
Saint Louis, MO 63110-3621
Phone
(314) 606-6011
NPI assigned
Jun 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2026025437 MO Primary

Addresses

Primary practice location

4045 Shaw Blvd FL 1
Saint Louis, MO 63110-3621

Mailing address

4045 Shaw Blvd FL 1
Saint Louis, MO 63110-3621
Phone (314) 606-6011

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": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1023942836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 SHAW BLVD FL 1",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103621",
            "telephone_number": "314-606-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 SHAW BLVD FL 1",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103621",
            "telephone_number": "314-606-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "LOGAN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2026025437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.