Jennifer B Logan, MD

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

MD461707 Issued in PA

Practice address

160 E Erie Ave
Philadelphia, PA 19134-1011

Phone

(215) 427-5085

NPI assigned

Jun 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Pediatric MedicineAlso: Pulmonary Disease

Education

Louisiana State University School of Medicine in New Orleans, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbouso423325@direct2.lvhn.org

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.

• Lehigh Valley Physician Group

  dba LVPG Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment Care Compare group
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Emergency Medicine - E. Erie A

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Philadelphia, PA
  • NPI 1144864547
  Medicare reassignment NPD
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650

  Pediatrics

  NPD
• Lehigh Valley Physician Group

  dba LVPG - Nephrology

  • Nephrology Physician
  • Allentown, PA
  • NPI 1730476557
  NPD
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Bethanna Developmental

  • Developmental - Behavioral Pediatrics Physician
  • Southampton, PA
  • NPI 1023656949
  NPD
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Ophthalmology - Newtown Yardley

  • Ophthalmology Physician
  • Newtown, PA
  • NPI 1548141997

  Pediatrics

  NPD

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1093120966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1657 Trinity Dr",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325045708",
            "country_code": "US",
            "telephone_number": "850-416-7710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "318-422-4641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 S Cedar Crest Blvd Ste 2700",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036239",
            "country_code": "US",
            "telephone_number": "610-402-3866",
            "fax_number": "610-402-3859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "JENNIFER",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD461707",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "TRN20430",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "PA",
            "license": "MD461707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayesha Nicole Logan, CRNP
• Caitlin Logan
• Gail Logan, MHS
• Gayle Vence Logan, MA,LMSW,LPC
• Jade Logan, PH.D., ABPP
• Roxanne Yolanda Logan, LCSW
• Susan Logan, CRNA
• Jazmin A Logendra, O.D.
• Logic Eyecare Inc
• Lia S Logio, MD

• Pediatric Pulmonology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Pulmonology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.