Individual provider Active NPI

Logan C Martin, DC

  • Chiropractor
  • Spokane Valley, WA
National Provider Identifier
1265627632
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034813 Issued in WA
Practice address
15404 E Springfield Ave
Suite 100
Spokane Valley, WA 99037-8569
Phone
(509) 892-9800
Fax
(509) 892-9998
NPI assigned
Sep 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034813 WA Primary

Addresses

Primary practice location

15404 E Springfield Ave
Suite 100
Spokane Valley, WA 99037-8569

Mailing address

15404 E Springfield Ave
Suite 100
Spokane Valley, WA 99037-8569
Phone (509) 892-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000349 ID Practitioner - Chiropractic 3779679675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Logan C Martin PCGroup PAC ID 1658534599, 2 clinicians

Practice addresses (Care Compare)

1104 N 4TH St
Suite B
Coeur D Alene, ID 83814-2418

1104 N 4TH St
Suite B
Coeur D Alene, ID 83814-3217
Phone (208) 292-4873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Logan C Martin PC Chiropractor CurrentSince Apr 10, 2012 Accepting new patients
Chiropractic Health Strategies, PA Chiropractor Past Accepting new patients
Gina M Wolf DC PS Chiropractor PastSince Sep 1, 2014 Accepting new patients

Locations

1104 N 4th St
#B
Coeur D Alene, ID 83814
Phone (208) 292-4873

1019 W Lacrosse Ave
Coeur D Alene, ID 83814
Phone (208) 292-4873

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1265627632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15404 E SPRINGFIELD AVE",
            "address_2": "SUITE 100",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378569",
            "telephone_number": "509-892-9800",
            "fax_number": "509-892-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15404 E SPRINGFIELD AVE",
            "address_2": "SUITE 100",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378569",
            "telephone_number": "509-892-9800",
            "fax_number": "509-892-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LOGAN",
        "middle_name": "C",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.