Tina M Logan, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH 3715 Issued in AL

Practice address

2555 Highway 78 E
Jasper, AL 35501-3433

Phone

(205) 385-7919

Fax

(205) 803-6458

NPI assigned

Feb 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Innerfit West, LLC

  • Physical Therapy Clinic/Center
  • Montgomery, AL
  • NPI 1396780706

  Physical Therapist

  NPD (past) Authorized official
• Drayer Physical Therapy Alabama LLC

  • Physical Therapy Clinic/Center
  • Northport, AL
  • NPI 1417593625
  NPD
• Drayer Physical Therapy-Alabama, LLC

  • Physical Therapist
  • Gardendale, AL
  • NPI 1023440583
  NPD

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1073654778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 HIGHWAY 78 E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355013433",
            "telephone_number": "205-385-7919",
            "fax_number": "205-803-6458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361061541",
            "country_code": "US",
            "telephone_number": "334-262-6878",
            "fax_number": "334-262-6258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH 3715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER TAX ID",
            "identifier": "71-0945220",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER TAX ID",
            "identifier": "63-1196634",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lifeworks Psychiatric Center, LLC
• Lighthouse Therapy LLC
• Russell Lockhart, LPTA
• Brittany Loebler, LICSW
• Maxanne Weeks Loftis, RPH
• Charity Lomneck, CRNP
• Douglas James Long, RN
• Jessica Lott, LMSW
• Susan Lowe
• Tina L Lubsen, AU.D., CCC-A

• Physical Therapist in Jasper, AL
• Providers in Jasper, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.