Individual provider Active NPI

Logen Breehl, DO

  • Pediatric Sports Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1164051413
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
34.016309 Issued in OH
Practice address
3333 Burnet Ave
Cincinnati, OH 45229
Phone
(513) 636-4200
NPI assigned
Apr 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34.016309 OH
Pediatric Sports Medicine Physician 2080S0010X 06118 KY
Pediatric Sports Medicine Physician 2080S0010X 34.016309 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
Cincinnati, OH 45229

Mailing address

1528 Southcross Dr
Hebron, KY 41048-6707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251029003200 OH Practitioner - Sports Medicine 7618466756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Campbell Univ School of Osteopathic Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06118KYMDPediatric Sports Medicine Physician
34.016309OHMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Pediatrics CurrentSince Aug 17, 2025 Accepting new patients
Englender Sper & Drasnin, M.D.'S Inc Pediatrics Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

2765 Chapel Pl
Crestview Hills, KY 41017
Phone (859) 344-1900

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

7777 Yankee Rd
#16016
Liberty Township, OH 45044
Phone (513) 803-9600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1200/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1164051413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 SOUTHCROSS DR",
            "city": "HEBRON",
            "state": "KY",
            "postal_code": "410486707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEHL",
        "first_name": "LOGEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.016309",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "KY",
            "license": "06118",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "OH",
            "license": "34.016309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.