Active NPI
Logan Richardson, OTR/L
- Occupational Therapist
- Phoenix, AZ
National Provider Identifier
1235819491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTH-010369
- Practice address
- 20330 N Cave Creek Rd Ste a-150
Phoenix, AZ 85024-4465 - Phone
- (602) 765-4338
- Fax
- (602) 765-4761
- NPI assigned
- Jul 24, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 125113 | TX | |
| Occupational Therapist | 225X00000X | OTH-010369 | AZ | Primary |
Addresses
Primary practice location
20330 N Cave Creek Rd Ste a-150
Phoenix, AZ 85024-4465
Mailing address
1860 N 95TH LN Ste 105
Phoenix, AZ 85037-4333
Phone (602) 765-4338
Other practice location 1
2001 N MacArthur Blvd Ste 550
Irving, TX 75061-2255
Phone (972) 990-8155
Other practice location 2
510 N Coit Rd Ste 2035
Richardson, TX 75080-5437
Phone (972) 437-2048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
20330 N Cave Creek Rd
Suite a 150
Phoenix, AZ 85024-4465
Phone (602) 765-4338
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTH-010369 | AZ | MD | Occupational Therapist |
| 125113 | TX | MD | Occupational Therapist |
Organizations & group practices 1
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.
-
- Occupational Therapist
- Phoenix, AZ
- NPI 1629137997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779840000000",
"number": "1235819491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 N 95TH LN STE 105",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850374333",
"telephone_number": "602-765-4338",
"fax_number": "602-765-4761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20330 N CAVE CREEK RD STE A-150",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850244465",
"telephone_number": "602-765-4338",
"fax_number": "602-765-4761"
}
],
"practiceLocations": [
{
"address_1": "2001 N MacArthur Blvd Ste 550",
"address_purpose": "LOCATION",
"city": "Irving",
"state": "TX",
"postal_code": "750612255",
"country_code": "US",
"telephone_number": "972-990-8155",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "510 N Coit Rd Ste 2035",
"address_purpose": "LOCATION",
"city": "Richardson",
"state": "TX",
"postal_code": "750805437",
"country_code": "US",
"telephone_number": "972-437-2048",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RICHARDSON",
"first_name": "LOGAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-24",
"last_updated": "2026-05-27",
"certification_date": "2026-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "125113",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-010369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.