Individual provider Active NPI

Logan Stanmore Richardson, DO

  • Family Medicine Physician
  • Winter Garden, FL
National Provider Identifier
1124760236
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS20623 Issued in FL
Practice address
153 Sugar Belle Dr Ste J
Winter Garden, FL 34787-8385
Phone
(321) 766-4985
NPI assigned
Apr 9, 2022
Last updated
Jul 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023-03181 NC
Family Medicine Physician 207Q00000X OS20623 FL Primary

Addresses

Primary practice location

153 Sugar Belle Dr Ste J
Winter Garden, FL 34787-8385

Mailing address

153 Sugar Belle Dr Ste J
Winter Garden, FL 34787-8385
Phone (321) 766-4985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240218000110 NC Practitioner - Family Practice 4981085180 Reassigns benefits to 1 organization
I20250731000441 FL Practitioner - Family Practice 4981085180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Campbell Univ School of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

153 Sugar Belle Dr
Suite J
Winter Garden, FL 34787-8385
Phone (321) 766-4985

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2023-03181NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Adventist Health System Sunbelt Inc Family Medicine Current Accepting new patients
Vidant Medical Group LLC CurrentSince Jan 10, 2024 Accepting new patients
Adventist Health System Sunbelt, Inc Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Adventist Health System/Sunbelt, Inc. Family Medicine Past Accepting new patients

Locations

2600 Westhall Ln
Maitland, FL 32751
Phone (407) 200-2273

4660 13th St
Saint Cloud, FL 34769
Phone (321) 805-4650

153 Sugar Belle Dr
Ste J
Winter Garden, FL 34787
Phone (321) 766-4985

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

101 Clinic Dr
Tarboro, NC 27886
Phone (252) 823-2105

Interoperability endpoints

  • Direct secure messaging: lrichardson5227287@adventhealth.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1649462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1124760236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 SUGAR BELLE DR STE J",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878385",
            "telephone_number": "321-766-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 SUGAR BELLE DR STE J",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878385",
            "telephone_number": "321-766-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "LOGAN",
        "middle_name": "STANMORE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-09",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-03181",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS20623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.