Logan Park Care Center, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

86 Issued in WV

Legal business name

LOGAN PARK CARE CENTER, INC.

Practice address

1000 W Park Ave
Logan, WV 25601-3155

Phone

(304) 752-8761

Fax

(304) 752-8768

NPI assigned

Oct 10, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Sphatt

Title

Chief of Operations & Finance

Phone

(304) 752-8761

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114915519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W PARK AVE",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013155",
            "telephone_number": "304-752-8761",
            "fax_number": "304-752-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W PARK AVE",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013155",
            "telephone_number": "304-752-8761",
            "fax_number": "304-752-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN PARK CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPHATT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHIEF OF OPERATIONS & FINANCE",
        "authorized_official_telephone_number": "304-752-8761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "WV",
            "license": "86",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003949000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logan Internal Medicine Group
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• Logan Oncology Care Associates, LLC
• Logan Pediatrics, Inc
• Logan Pediatrics, Inc
• Logan Professional Counseling Services
• Logan Professional Counseling Services
• Logan Regional Anesthesia Services, LLC

• Nursing Facility/Intermediate Care Facility in Logan, WV
• Providers in Logan, WV by specialty
• Nursing Facility/Intermediate Care Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.