NPIMap

Organization Active NPI

Logan Memorial Hospital

Doing business as Logan Care for Women

  • Obstetrics & Gynecology Physician
  • Russellville, KY
National Provider Identifier
1245263631
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LOGAN MEMORIAL HOSPITAL
Doing business as
Logan Care for Women
Practice address
1623 Nashville St
Suite 105
Russellville, KY 42276-8889
Phone
(615) 372-8500
NPI assigned
Jul 8, 2006
Last updated
Jun 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Johnetta Traylor
Title
Ao
Phone
(502) 596-6063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

1623 Nashville St
Suite 105
Russellville, KY 42276-8889

Mailing address

680 S 4TH St # KH-3
Louisville, KY 40202-2407
Phone (502) 596-6063

Other names 1

  • Logan Care for Women Doing business as

National Provider Directory

National Provider Directory

Locations

1623 Nashville St
Ste 105
Russellville, KY 42276
Phone (270) 265-5010

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26087/brand/2/csg/21/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1245263631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST # KH-3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 NASHVILLE ST",
            "address_2": "SUITE 105",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422768889",
            "telephone_number": "615-372-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan Care for Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Russellville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.