Active NPI
Connor Michael Logoyda
- Athletic Trainer
- Brownsville, PA
National Provider Identifier
1083133052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT007800
- Practice address
- 5 Falcon Dr
Brownsville, PA 15417-2200 - Phone
- (973) 294-5802
- NPI assigned
- Sep 11, 2017
- Reactivated
- May 25, 2021
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT007800 | PA | Primary |
Addresses
Primary practice location
5 Falcon Dr
Brownsville, PA 15417-2200
Mailing address
334 Cemetery Rd
Perryopolis, PA 15473-1039
Phone (973) 294-5802
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 |
|---|---|---|---|
| RT007800 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1083133052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 CEMETERY RD",
"city": "PERRYOPOLIS",
"state": "PA",
"postal_code": "154731039",
"telephone_number": "973-294-5802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 FALCON DR",
"city": "BROWNSVILLE",
"state": "PA",
"postal_code": "154172200",
"telephone_number": "973-294-5802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGOYDA",
"first_name": "CONNOR",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-11",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"deactivation_date": "2018-03-19",
"reactivation_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT007800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brownsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.