Active NPI
Logan Rodriguez, PT
- Physical Therapist
- Salt Lake City, UT
National Provider Identifier
1194141820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12509010-2401
- Practice address
- 100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-1000
- NPI assigned
- Mar 5, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1240459 | TX | |
| Physical Therapist | 225100000X | 12509010-2401 | UT | Primary |
Addresses
Primary practice location
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
PO Box 30180
Salt Lake City, UT 84130-0180
Other practice location 1
11800 Fm 1960 Rd W
Houston, TX 77065-3840
Phone (281) 664-2107
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80TT54 | Other | TX | BC/BS PROVIDER TRANSACTION NUMBER |
Other names 1
- Logan Winegar
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12509010-2401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1194141820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30180",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-1000"
}
],
"practiceLocations": [
{
"address_1": "11800 Fm 1960 Rd W",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770653840",
"country_code": "US",
"telephone_number": "281-664-2107",
"fax_number": "281-955-5875",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "LOGAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-05",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1240459",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "12509010-2401",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER TRANSACTION NUMBER",
"identifier": "80TT54",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LOGAN",
"last_name": "WINEGAR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.