Individual provider Active NPI

Donna L Logan, MD

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1083676084
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24165 Issued in KS
Practice address
855 N Hillside St
Wichita, KS 67214-4913
Phone
(316) 685-1381
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24165 KS Primary

Addresses

Primary practice location

855 N Hillside St
Wichita, KS 67214-4913

Mailing address

855 N Hillside St
Wichita, KS 67214-4913
Phone (316) 685-1381

Other identifiers 1

IdentifierTypeStateIssuer
100155350AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000755 KS Practitioner - Family Practice 2365484193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillside Medical Office LLCGroup PAC ID 6709823453, 9 clinicians

Practice addresses (Care Compare)

855 N Hillside St
Wichita, KS 67214-4913
Phone (316) 719-1554

Hospital & facility affiliations

  • Wesley Medical Center Hospital, Wichita, KS, CCN 170123

Merit-based Incentive Payment System (MIPS)

Final score
91.13 of 100Reported as group
Quality
100
Promoting interoperability
99
Improvement activities
40
Cost
71.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24165KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hillside Medical Office LLC Family Medicine CurrentSince Nov 30, 1994 Accepting new patients

Locations

855 N Hillside St
Wichita, KS 67214
Phone (316) 685-1381

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECFFCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/ECFFCD/Endpoint/ECFFCD

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1083676084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144913",
            "telephone_number": "316-685-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144913",
            "telephone_number": "316-685-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "DONNA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "24165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100155350A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.