Logan Physician Practice, LLC
Organization Active NPI Nurse Practitioner · Auburn, KY
NPI 1265740765 · NPPES record last updated Jul 3, 2024
Key facts
- NPI
- 1265740765
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- LOGAN PHYSICIAN PRACTICE, LLC
- Practice address
- 128 Sugar Maple Drive
Auburn, KY 42206 - Phone
- (615) 957-0847
- NPI assigned
- Sep 17, 2010
- Organization subpart
- No
Authorized official
- Name
- Kathy J Teague
- Title
- Vice President and Corp Secretary
- Phone
- (629) 253-5121
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 3
Practitioners 17
-
Erinn Lynn Basista, DNP, APRN, FNP-C
-
Cynthia Jo Bond, APRN
-
Abhilasha M. Singh, M.D.
-
Janie Elizabeth Davis, ARNP
-
Adam Wesley Ellis, M.D
-
Kristen Erica Hunkin, PHD, PMHNP-BC, FNP-C
-
Blair R Mendoza, APRN
-
Kimberly Ann Owens, APRN
-
Steve G Salyers, MD
-
James Marvin Staples, ARNP
-
Stacia Ashley Staples, ARNP
-
Kelly S Tate, MD
-
Melissa Anne Allen, APRN
-
Whitney S. Sowell, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040219000212 | KY | Part B Supplier - Clinic/Group Practice | 4880596592 |
Receives reassigned benefits from 14 practitioners 3 other NPIs on this enrollment Practice locations: Auburn, KY; Elkton, KY; Russellville, KY |
National Provider Directory
- Tax ID family
- Logan Physician Practice
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
128 Sugar Maple Drive
Auburn, KY 42206
Mailing address
128 Sugar Maple Drive
Auburn, KY 42206
Phone (615) 957-0847
Other names
- Auburn Community Family Clinic
Other providers in Auburn, KY
- Heartland Family Pharmacy LLC
- Austin Brooke Higgins
- Sara Adkins Horton
- Tara M Jackson
- Logan Physician Practice LLC
- Krista Nash-Posey
- Cindy Pawley
- Stefanie Layne Shrull
- Jessica Smith
- Barry W Stahl
All providers in Auburn, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.