Active NPI
Michelle Logan
- Geriatric Physical Therapist
- Salinas, CA
National Provider Identifier
1063867943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- PT-39557
- Practice address
- 350 Iris Dr
Salinas, CA 93906-3514 - Phone
- (831) 449-1515
- NPI assigned
- Apr 28, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | PT-39557 | CA | Primary |
Addresses
Primary practice location
350 Iris Dr
Salinas, CA 93906-3514
Mailing address
1709 Independence Blvd
Apt 205
Salinas, CA 93906-5382
Phone (724) 316-9055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-39557 | CA | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461801600000",
"number": "1063867943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1709 INDEPENDENCE BLVD",
"address_2": "APT 205",
"city": "SALINAS",
"state": "CA",
"postal_code": "939065382",
"telephone_number": "724-316-9055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 IRIS DR",
"city": "SALINAS",
"state": "CA",
"postal_code": "939063514",
"telephone_number": "831-449-1515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-28",
"last_updated": "2016-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "CA",
"license": "PT-39557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salinas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.