Stephanie Logan, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

838762 Issued in NV

Practice address

2770 S Maryland Pkwy Ste 200
Las Vegas, NV 89109-1554

Phone

(702) 478-9594

NPI assigned

Sep 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stephanie N Logan Other name

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Golan Integrated Physical Medicine

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Las Vegas, NV
  • NPI 1497195580
  Medicare reassignment NPD
• Santa Rosa Medical Centers of Nevada, Inc.

  • Urgent Care Clinic/Center
  • Las Vegas, NV
  • NPI 1912155110
  Medicare reassignment NPD
• Golan Integrated Physical Medicine

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
  • NPI 1316419260
  NPD
• A Nicknam PC

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1659501302
  NPD (past)

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1285248898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 561564",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802566672",
            "telephone_number": "702-478-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 S MARYLAND PKWY STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891091554",
            "telephone_number": "702-478-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "STEPHANIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "838762",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "LOGAN",
            "middle_name": "N",
            "credential": "FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lori Alice Logan, CGC
• Mechel'la Lafay Logan
• Melissa Logan
• Sandra Logan
• Sharonda Logan
• Tamara Logan
• William Logan
• Mylene Loganzdanis, RDN, LD
• Latasha Loggins
• Mistie Loggins, FNP-C

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.