South Logan Family Practice Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26202 Issued in CO

Legal business name

SOUTH LOGAN FAMILY PRACTICE CENTER

Practice address

895 S Logan St
Denver, CO 80209-4197

Phone

(303) 733-3764

Fax

(303) 733-0868

NPI assigned

Jul 3, 2007

Organization subpart

No

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

Authorized official

Name

Vicki Laws

Title

Office Manager

Phone

(303) 733-3764

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

South Logan Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• South Logan Family Practice

  • Physician Assistant
  • Denver, CO
  • NPI 1659789733
  NPD tax ID

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1053519868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 S LOGAN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094197",
            "telephone_number": "303-733-3764",
            "fax_number": "303-733-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 S LOGAN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094197",
            "telephone_number": "303-733-3764",
            "fax_number": "303-733-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LOGAN FAMILY PRACTICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "LAWS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "303-733-3764"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "26202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01262021",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Denver Neurosurgery Assistance, LLC
• South Federal Dental GP PC
• South Federal Dental Partners PLLC (Comfort Dental of South Denver)
• South Federal Family Practice
• South Logan Family Practice
• South Logan Medical Management SVCS LLC
• South Valley Physical Therapy PC
• Southbridge Partners II (Cherry Creek Family Dentistry)
• Southeast Dental Arts LLC
• Southeast Dental Arts,LLC

• Family Medicine Physician in Denver, CO
• Providers in Denver, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.