Individual provider Active NPI

Logan Brennan, DC, ATC

  • Chiropractor
  • Dunedin, FL
National Provider Identifier
1164949202
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14709 Issued in FL
Practice address
1022 Main St Ste a
Dunedin, FL 34698-5237
Phone
(727) 238-7208
NPI assigned
Aug 29, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL6002 FL
Chiropractor 111N00000X CH14709 FL Primary

Addresses

Primary practice location

1022 Main St Ste a
Dunedin, FL 34698-5237

Mailing address

19375 US Highway 19 N Apt 307
Clearwater, FL 33764-3320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH14709FLMDChiropractor
AL6002FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1164949202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19375 US HIGHWAY 19 N APT 307",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337643320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 MAIN ST STE A",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346985237",
            "telephone_number": "727-238-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "DC, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-29",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL6002",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.