Logan Willhite

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106014 Issued in MN

Practice address

1025 Marsh St
Mankato, MN 56001

Phone

(507) 625-4031

NPI assigned

Mar 11, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, 658 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1093176547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30479 County Highway 4",
            "address_purpose": "LOCATION",
            "city": "Sanborn",
            "state": "MN",
            "postal_code": "560833031",
            "country_code": "US",
            "telephone_number": "507-227-6122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30479 County Highway 4",
            "address_purpose": "LOCATION",
            "city": "Sanborn",
            "state": "MN",
            "postal_code": "560833031",
            "country_code": "US",
            "telephone_number": "507-227-6122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560015473",
            "country_code": "US",
            "telephone_number": "507-385-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 N Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MN",
            "postal_code": "560871714",
            "country_code": "US",
            "telephone_number": "507-723-6201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLHITE",
        "first_name": "LOGAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-11",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwillhite480041@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madison Ann Wilde
• Wildrose Home Health Services, Inc.
• Amanda Jean Wilkening, MOTR/L
• Kara Ilene Will, BS, LADC-S
• Sophie Willems, OTR/L
• Brian P Williams, MD
• Kay S Williams, APNP
• Kaylyn Williams
• Lucian Reed Williams
• Paul Daniel Williams, D.O.

• Occupational Therapist in Mankato, MN
• Providers in Mankato, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.