Jerry W Logan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001503B Issued in IN

Practice address

2519 E Main St
Richmond, IN 47374-5867

Phone

(765) 966-2661

Fax

(765) 965-4789

NPI assigned

Dec 11, 2006

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

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlogan307806@ecommunitydirect.com

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.

• DRS Logan & Bailey Optometrists Inc

  • Optometrist
  • Richmond, IN
  • NPI 1962568709
  Medicare reassignment NPD Authorized official
• Evans Eye Care Inc

  • Optometrist
  • Lafayette, IN
  • NPI 1992784599
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1043370125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 EAST MAIN STREET",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473745867",
            "telephone_number": "765-966-2661",
            "fax_number": "765-965-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 E MAIN ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473745867",
            "telephone_number": "765-966-2661",
            "fax_number": "765-965-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "JERRY",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001503B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiana Lincicome
• Jeremy Arthur Lindahl, D.O.
• Manda Lindsey, RBT
• Mrudula Dora Lingala, PT
• Links for Life, LLC
• Dorothy B. Lollathin, PA-C
• Lonestar Family Practice
• Andria Long
• Shaun Long
• Tammy Long, LPN

• Optometrist in Richmond, IN
• Providers in Richmond, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.