NPIMap

Individual provider Active NPI

Lisa Marie Logan, PA-C

  • Physician Assistant
  • Tonopah, NV
National Provider Identifier
1114098464
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1023 Issued in NV
Practice address
825 S Main St.
Tonopah, NV 89049
Phone
(775) 982-8255
Fax
(775) 982-3900
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 9

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 9

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLC 630 clinicians
Eastern Sierra Medical Group LLC 2 clinicians

Practice addresses (Care Compare)

1343 Newlands Dr W
Fernley, NV 89408-8926
Phone (775) 982-5000

3595 US Hwy 50
Silver Springs, NV 89429-9613
Phone (775) 982-5000

Hospital & facility affiliations

  • Eden Home Health Home health agency, Reno, NV, CCN 297035
  • Centerwell Home Health Home health agency, Reno, NV, CCN 297022
  • Mission Home Health of Carson City Home health agency, Carson City, NV, CCN 297249
  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049
  • Banner Churchill Community Hospital Hospital, Fallon, NV, CCN 291313
  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20070727000352 NV Practitioner - Physician Assistant 6305947862 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC Physician Assistant CurrentSince Apr 16, 2020 Accepting new patients
Community Care Services LLC CurrentSince Apr 16, 2020 Accepting new patients
Community Care Services LLC Past Accepting new patients
Community Care Services LLC Past Accepting new patients
Linda L. Johnson MD, LTD Past Accepting new patients

Locations

1343 Newlands Dr W
Fernley, NV 89408
Phone (775) 575-3600

850 Harvard Way
#T5
Reno, NV 89502

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

975 Ryland St
Ste 100
Reno, NV 89502
Phone (775) 982-5210

850 Harvard Way
Reno, NV 89502

Interoperability endpoints

  • Direct secure messaging: llogan18792@direct.umcsn.com
  • Direct secure messaging: llogan2276@direct.renown.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1023 NV Primary

Addresses

NPPES NPI Registry

Primary practice location

825 S Main St.
Tonopah, NV 89049

Mailing address

850 Harvard Way # T5
Reno, NV 89502-2055
Phone (775) 982-5262

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 23, 2018.

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1114098464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY # T5",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S MAIN ST.",
            "city": "TONOPAH",
            "state": "NV",
            "postal_code": "89049",
            "telephone_number": "775-982-8255",
            "fax_number": "775-982-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonopah, NV

Sources for this page

Verify at the official NPI Registry.