Individual provider Active NPI

Ellen Logan, CTRS, TRS

  • Recreation Therapist
  • Springville, UT
National Provider Identifier
1194537233
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
License
12454141-4002 Issued in UT
Practice address
266 Left Fork Hobble Creek Canyon Rd
Springville, UT 84663
Phone
(385) 500-3529
NPI assigned
Jan 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X 12454141-4002 UT Primary

Addresses

Primary practice location

266 Left Fork Hobble Creek Canyon Rd
Springville, UT 84663

Mailing address

5500 Ming Ave Ste 265
Bakersfield, CA 93309-4696

Other identifiers 1

IdentifierTypeStateIssuer
12454141-4002OtherUTLICENSE

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
12454141-4002UTMDRecreation Therapist

NPI Registry JSON

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1194537233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MING AVE STE 265",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933094696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 LEFT FORK HOBBLE CREEK CANYON RD",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "84663",
            "telephone_number": "385-500-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "ELLEN",
        "credential": "CTRS, TRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "UT",
            "license": "12454141-4002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "12454141-4002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.