Logan Bryant Colbaugh

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

615 McCallie Ave
Chattanooga, TN 37403-2504

Phone

(423) 425-1741

NPI assigned

Jan 8, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1245040856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 OLD MCCLURE RD SE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373238340",
            "telephone_number": "423-464-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032504",
            "telephone_number": "423-425-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBAUGH",
        "first_name": "LOGAN",
        "middle_name": "BRYANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000253901",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Cohagen, PHARM. D.
• Cori Cohen, OTD, OTR/L
• Jonathan S Cohen, MD
• Samantha Cohen
• Dora B Coker, RN, BSN
• Jeffrey S. Colburn, MD
• Alexandra Colclough
• Cole Vision Corporation
• Daniel Jay Cole, M. DIV., MAC
• Darwin Reid Cole, BS

• All providers in Chattanooga, TN
• Student in an Organized Health Care Education/Training Program in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.