Logan M Kissell

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

03439762 Issued in OH

Practice address

305 W Main St
Ottawa, OH 45875-1725

Phone

(419) 523-6030

NPI assigned

Jul 7, 2020

Sex

Male

Sole proprietor

Yes

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.

• Rite Aid of Ohio Inc

  • Community/Retail Pharmacy
  • Ottawa, OH
  • NPI 1669581906
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 13, 2020.

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1033737150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 PARK PLAZA DR APT 301",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152293125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W MAIN ST",
            "city": "OTTAWA",
            "state": "OH",
            "postal_code": "458751725",
            "telephone_number": "419-523-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSELL",
        "first_name": "LOGAN",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "03439762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Deborah Kamin, DDS
• Erica Karhoff
• Janice Patricia Kaufman, PH.D.
• Kristine Renee Kaufman, CNP
• Kiddos ABA Therapy, LLC
• Klass Apothecary Inc
• Klass Apothecary Inc
• James Kleman, RPH
• Logan Kline
• Linda Sue Knowlton, ED.D.

• All providers in Ottawa, OH
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.