Logan Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LOGAN FAMILY PRACTICE LLC

Practice address

1719 Nashville St
Russellville, KY 42276-7804

Phone

(270) 726-7664

NPI assigned

Jul 19, 2021

Organization subpart

No

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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Logan Family Practice LLC

  • Rural Health Clinic/Center
  • Russellville, KY
  • NPI 1699447169

  O20210928000378

  Same enrollment

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erinn Lynn Basista, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Russellville, KY
  • NPI 1457954471
  Medicare reassignment Care Compare group NPD
• Patrick Kevin Hayden, M.D.

  • Family Medicine Physician
  • Russellville, KY
  • NPI 1295847184
  Medicare reassignment Care Compare group NPD
• Melissa D Corbin

  • Nurse Practitioner
  • Russellville, KY
  • NPI 1922678143

  Family

  Medicare reassignment NPD
• Melissa Anne Allen, APRN

  • Nurse Practitioner
  • Bowling Green, KY
  • NPI 1164924130
  Care Compare group
• Whitney S. Sowell, APRN

  • Family Nurse Practitioner
  • Bowling Green, KY
  • NPI 1346811262
  Care Compare group

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1285207241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "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": "1719 NASHVILLE ST",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422767804",
            "telephone_number": "270-726-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifeline Home Health Care of Russellville, LLC
• Heather Lindenberg, MS E.D., ATC
• Logan County Board of Education
• Logan County Eye Associates
• Logan Emergency Group LLC
• Logan Family Practice LLC
• Logan Memorial Hospital
• Logan Memorial Hospital
• Logan Memorial Hospital LLC
• Logan Memorial Hospital LLC

• Family Medicine Physician in Russellville, KY
• Providers in Russellville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.