Logan Debord, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

DR.0069923 Issued in CO

Practice address

984 N 10 Mile Dr
#103
Frisco, CO 80443-5719

Phone

(970) 668-0998

NPI assigned

Mar 27, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Dermatology

Education

Baylor College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology of Colorado LLCGroup PAC ID 8921354341, 18 clinicians

Bella Derma, LLCGroup PAC ID 2466424072, 20 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.01 of 100Reported as group

Quality

100

Improvement activities

40

Cost

83.36

Merit-based Incentive Payment System (MIPS)

Final score

95.67 of 100Reported as group

Quality

99.21

Improvement activities

40

Cost

86.61

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Bella Derma, LLC

  • Dermatology Physician
  • Edwards, CO
  • NPI 1730106642
  Medicare reassignment Care Compare group NPD
• Epiphany Dermatology of Colorado, LLC

  • Dermatology Physician
  • Denver, CO
  • NPI 1992297469
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1104387794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RANCH ROAD 2222, BUILDING 1, STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78730",
            "telephone_number": "512-628-0465",
            "fax_number": "512-233-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 N 10 MILE DR",
            "address_2": "#103",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804435719",
            "telephone_number": "970-668-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBORD",
        "first_name": "LOGAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0069923",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Kay Darricau, MD
• Brian W Davis, PA-C
• Kathryn A Davis, MA
• Day Surgical Arts Frisco
• Teri Lynn Day, PT
• Nicole Marie Denczek, PT
• Marshall Esty Denkinger Jr., MD
• Destination Dermatology LLC
• Christian Abner Diaz
• Carolyn Christiano Dieter, PT

• Dermatology Physician in Frisco, CO
• Providers in Frisco, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.