Logan Michael Richard

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

112660 Issued in IA

Practice address

789 Holton Dr
Le Mars, IA 51031-3757

Phone

(712) 546-1718

NPI assigned

Oct 21, 2021

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

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Le Mars Physical TherapyGroup PAC ID 3375617962, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Le Mars Physical Therapy

  • Physical Therapy Clinic/Center
  • Le Mars, IA
  • NPI 1932369352

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Lemars Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Le Mars, IA
  • NPI 1356556898
  NPD (past)

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1265195606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 11TH ST SW UNIT B1",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510312562",
            "telephone_number": "712-369-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 HOLTON DR",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510313757",
            "telephone_number": "712-546-1718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4230 Hickory Ln Apt 124",
            "address_purpose": "LOCATION",
            "city": "Sioux City",
            "state": "IA",
            "postal_code": "511064605",
            "country_code": "US",
            "telephone_number": "712-369-3057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "LOGAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-21",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "112660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyndsi Price, PHARMD
• Cassandra Prieksat, CADC TEMP
• Diana Kay Rann, RN
• Jordan Ann Reed, MOT, OTR/L
• Lindy Sue Reinhart, TLMHC
• William Rieken
• Christel Jean Rinehart, ARNP
• Ritz Chiropractic Group PLLC
• Travis John Ritz, DC
• Amanda Robinson, RN

• Physical Therapist in Le Mars, IA
• Providers in Le Mars, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.

Verify at the official NPI Registry.