Active NPI
Logan Prescott
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Springfield, MO
National Provider Identifier
1073168399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 2018029949
- Practice address
- 3545 S National Ave
Springfield, MO 65807-7310 - Phone
- (417) 269-3282
- NPI assigned
- Aug 4, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 2018029949 | MO | Primary |
Addresses
Primary practice location
3545 S National Ave
Springfield, MO 65807-7310
Mailing address
5650 E Farm Road 132
Springfield, MO 65802-9494
Phone (417) 880-2865
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 |
|---|---|---|---|
| 2018029949 | MO | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564876800000",
"number": "1073168399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5650 E FARM ROAD 132",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658029494",
"telephone_number": "417-880-2865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3545 S NATIONAL AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658077310",
"telephone_number": "417-269-3282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESCOTT",
"first_name": "LOGAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-04",
"last_updated": "2019-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "MO",
"license": "2018029949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
- Premier Home Health Care, Inc.
- Premier Home Health Care, Inc.
- Premier Home Health Care, Inc.
- Premise Health of Missouri Medical PC
- Presbyterian Children'S Services, Inc.
- Kevin Michael Presley, DO
- Kendra L Price-Salyer, PSY.D., LP
- Amy Joslyn Price, HEALTH EDUCATOR
- Carl I Price, MD
- Hilary Morrow Price, O.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.