Individual provider Active NPI

Logan McKenzie Miller, FNP-C

  • Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1144899246
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3016215 Issued in KY
Practice address
1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone
(270) 444-2444
NPI assigned
Jun 22, 2021
Last updated
Aug 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3016215 KY Primary
Family Nurse Practitioner 363LF0000X 1127765 KY

Addresses

Primary practice location

1530 Lone Oak Rd
Paducah, KY 42003-7901

Mailing address

604 N 36TH St
Paducah, KY 42001-4719
Phone (270) 601-3685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210825002481 KY Practitioner - Nurse Practitioner 4981009107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Valley Hospital Medicine Physicians LLCGroup PAC ID 3779973839, 27 clinicians

Practice addresses (Care Compare)

1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone (270) 444-2444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as group
Improvement activities
40
Cost
75.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1127765KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Hospital Medicine Physicians, LLC Nurse Practitioner CurrentSince Oct 17, 2023 Accepting new patients

Locations

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

Interoperability endpoints

  • Direct secure messaging: lmiller187901@direct.bsmhealth.org

Organizations & group practices 1

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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1144899246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N 36TH ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014719",
            "telephone_number": "270-601-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LONE OAK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037901",
            "telephone_number": "270-444-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LOGAN",
        "middle_name": "MCKENZIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3016215",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "1127765",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.