Phillip K Logsdon, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016003166 Issued in IL

Practice address

1802 S. Mattis Avenue
Orthopedics
Champaign, IL 61821

Phone

(217) 383-3260

NPI assigned

Jul 20, 2006

Last updated

May 7, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1043230089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 S. MATTIS AVENUE",
            "address_2": "ORTHOPEDICS",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61821",
            "telephone_number": "217-383-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGSDON",
        "first_name": "PHILLIP",
        "middle_name": "K",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "480014262",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tania G Lodhi, DDS
• William Jerome Loethen
• Candace Logan
• Tiffany Nicole Logan, NP
• Andrew William Logeman, M.D.
• Kathryn Lohmeyer, MSW, LCSW
• Beverly Minolta London, MD
• Jack Henry Jake London, RBT
• Hillary Lopez, LPN
• Richard Grey Lord Sr., DDS

• Podiatrist in Champaign, IL
• Providers in Champaign, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.