Logan Nielson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

382 N Overland Ave
Burley, ID 83318-3433

Phone

(208) 678-6996

NPI assigned

Oct 10, 2018

Last updated

Oct 10, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

R. Bret Campbell, DO and Assoc, LLCGroup PAC ID 2860799905, 3 clinicians

Anthony J Anderson MD and Assoc LLCGroup PAC ID 5597064709, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lost Rivers Medical Center Hospital, Arco, ID, CCN 131324
• Cassia Regional Hospital Hospital, Burley, ID, CCN 131326

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Anthony J Anderson MD & Assoc LLC

  • Family Medicine Physician
  • Burley, ID
  • NPI 1558604231
  Medicare reassignment Care Compare group
• R Bret Campbell DO & Assoc LLC

  • Family Medicine Physician
  • Burley, ID
  • NPI 1952744641
  Medicare reassignment Care Compare group
• River View Urgent Care & Medical Center Inc

  • Urgent Care Clinic/Center
  • Burley, ID
  • NPI 1790043693
  Medicare reassignment
• Urgent Care of Idaho, LLC

  dba Urgent Care of Jerome

  • Urgent Care Clinic/Center
  • Jerome, ID
  • NPI 1538578687
  Medicare reassignment
• Urgent Care of Idaho, LLC

  dba Urgent Care of Idaho - Burley

  • Urgent Care Clinic/Center
  • Burley, ID
  • NPI 1841972122
  NPD

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

• Ihc Health Services, Inc.

  dba Intermountain Health Cassia Regional Hospital

  • General Acute Care Hospital
  • Burley, ID
  • NPI 1497865315
  Care Compare affiliation
• Lost Rivers Medical Center

  • Critical Access Hospital
  • Arco, ID
  • NPI 1114925047
  Care Compare affiliation

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1184199648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 DENNIS DR",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833183217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 N OVERLAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833183433",
            "telephone_number": "208-678-6996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2392 Addison Ave E",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833016745",
            "country_code": "US",
            "telephone_number": "208-933-4440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "133 W Avenue A",
            "address_purpose": "LOCATION",
            "city": "Jerome",
            "state": "ID",
            "postal_code": "833382630",
            "country_code": "US",
            "telephone_number": "208-324-2004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "LOGAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Nash, CMHC, LCPC
• Mark Steven Nelson, LMSW
• Zachary Nelson, DO
• New Horizons Mental Wellness Clinics
• Curtis Samuel Nielson, PA-C
• Thomas Andrew Nilsen, MS,PT
• Norco, Inc.
• Stewart Raymond North, D.O.
• Northland Hearing Center, Inc. (NuEar Hearing Center)
• Northwest Bec Corp Dba Burley Care Center

• Medical Physician Assistant in Burley, ID
• Providers in Burley, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.