NPIMap

Organization Active NPI

Logan Graddy MD PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Durham, NC
National Provider Identifier
1275967077
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
2007000070 Issued in NC
Legal business name
LOGAN GRADDY MD PLLC
Practice address
910 Broad St
Durham, NC 27705-4142
Phone
(919) 416-4191
Fax
(888) 805-6175
NPI assigned
Aug 28, 2013
Last updated
Aug 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Authorized official

Name
Dr. Logan Graddy, MDNPI 1932377280
Title
Owner
Phone
(919) 475-9160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2007000070 NC Primary

Addresses

Primary practice location

910 Broad St
Durham, NC 27705-4142

Mailing address

910 Broad St
Durham, NC 27705-4142
Phone (919) 416-4191

National Provider Directory

National Provider Directory

Locations

910 Broad St
Durham, NC 27705
Phone (919) 210-1448

Practitioners & affiliated clinicians

Practitioners 4

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": "1377648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1275967077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054142",
            "telephone_number": "919-416-4191",
            "fax_number": "888-805-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054142",
            "telephone_number": "919-416-4191",
            "fax_number": "888-805-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN GRADDY MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "GRADDY",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-475-9160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": "2007000070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.