Active NPI
Logan Prior, APRN
- Psychiatric/Mental Health Nurse Practitioner
- Salem, OR
National Provider Identifier
1063149755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 202210823
- Practice address
- 945 Columbia St NE Ste 8
Salem, OR 97301-7205 - Phone
- (503) 707-1950
- NPI assigned
- Aug 3, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 202210823 | OR | Primary |
Addresses
Primary practice location
945 Columbia St NE Ste 8
Salem, OR 97301-7205
Mailing address
5041 Foothills Rd Apt E
Lake Oswego, OR 97034-3215
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240115001774 | OR | Practitioner - Nurse Practitioner | 0840642823 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202210823 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1063149755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5041 FOOTHILLS RD APT E",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970343215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 COLUMBIA ST NE STE 8",
"city": "SALEM",
"state": "OR",
"postal_code": "973017205",
"telephone_number": "503-707-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIOR",
"first_name": "LOGAN",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-03",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "202210823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
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- Renee Carolyn Prins, M.D.
- J. Scott Pritchard, DO
- Joshua N Pritikin, PH.D.
- Denis Privalov, MD
- Procare Transportation LLC
- Procision Ramps LLC (Z Construction)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.