NPIMap

Organization Active NPI

Logan Radiology Group LLC

  • Diagnostic Radiology Physician
  • Logan, UT
National Provider Identifier
1043212988
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LOGAN RADIOLOGY GROUP LLC
Practice address
1400 N 500 E
Logan, UT 84341-2455
Phone
(281) 980-1430
NPI assigned
Aug 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
C Richard Hopkins, MD
Title
President
Phone
(801) 296-2113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X UT Primary

Addresses

Primary practice location

1400 N 500 E
Logan, UT 84341-2455

Mailing address

PO Box 1108
Bountiful, UT 84011-1108
Phone (801) 296-2113

Other identifiers 2

IdentifierTypeStateIssuer
119042300MedicaidWY
002979600MedicaidID

National Provider Directory

National Provider Directory

Locations

1400 N 500 E
Ste KB2
Logan, UT 84341

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1043212988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840111108",
            "telephone_number": "801-296-2113",
            "fax_number": "801-296-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412455",
            "telephone_number": "281-980-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN RADIOLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-296-2113",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119042300",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002979600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.