Brian J. Logue MD. PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

BRIAN J. LOGUE MD. PC

Practice address

2907 S. McIntire Dr
Bloomington, IN 47403-4224

Phone

(812) 332-8765

Fax

(812) 336-3425

NPI assigned

Jan 24, 2006

Organization subpart

No

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

Authorized official

Name

Brian J Logue, MDNPI 1467450767

Title

Owner

Phone

(812) 332-8765

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Summit Urology Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 4

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

• Brian J Logue, MD

  • Urology Physician
  • Bloomington, IN
  • NPI 1467450767
  Medicare reassignment NPD Authorized official
• Eric M Smith, M.D.

  • Urology Physician
  • Bloomington, IN
  • NPI 1578561700
  Medicare reassignment NPD
• Jennifer Keith, PA

  • Physician Assistant
  • Bloomington, IN
  • NPI 1275015901
  Medicare reassignment
• David R Elkins, PA

  • Medical Physician Assistant
  • Olympia, WA
  • NPI 1235137571

  IN

  Medicare reassignment

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1285604199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 MCINTYRE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034209",
            "telephone_number": "812-332-8765",
            "fax_number": "812-336-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 S. MCINTIRE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034224",
            "telephone_number": "812-332-8765",
            "fax_number": "812-336-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN J. LOGUE MD. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "LOGUE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-332-8765",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200175020A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000098138",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "CD6715",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harold Eugene Brewer, DDS
• Judson L Brewer, MD
• Margie Brewer
• Rebecca B Brewer, MD
• David A Brewster, DPT
• Tina S Brickert, CNM
• Alexis Brickner
• Esther J Briggs, CPNP
• Bright Life Hearing Care, LLC
• Brinegar Eye Care, LLC

• Urology Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Urology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.