Shannon L Logsdon, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011936 Issued in MI

Practice address

23200 Red Arrow Hwy Ste a
Mattawan, MI 49071-7754

Phone

(269) 668-5930

Fax

(269) 668-5921

NPI assigned

Jan 23, 2007

Last updated

Oct 25, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shannon L Hammond Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lacey Physical Therapy Center Incorporated

  • Specialist
  • Mattawan, MI
  • NPI 1164649497

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1114071487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4744 N COLOMA RD",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "490389543",
            "telephone_number": "269-487-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23200 RED ARROW HWY STE A",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490717754",
            "telephone_number": "269-668-5930",
            "fax_number": "269-668-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGSDON",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "HAMMOND",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anthony David Kopp, DC
• Sara Koprolces
• Sarah Kranak, MA, BCBA, LBA
• Lacey Physical Therapy Center Incorporated
• Kevin James Lacey, PT, DPT
• Janine Elizabeth Rigg Loughrin, M.S.W
• Mattawan Chiropractic Clinic, P.C.
• Mattawan Family Dentistry
• Mattawan Family Eye Care PLC
• Mattawan Pharmacy

• Physical Therapist in Mattawan, MI
• Providers in Mattawan, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.