Active NPI
Justin Pugh, BS
- Case Manager/Care Coordinator
- Logansport, IN
National Provider Identifier
1295080133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 2496 E County Road 125 N
Logansport, IN 46947-7931 - Phone
- (574) 722-4042
- NPI assigned
- Jul 17, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
2496 E County Road 125 N
Logansport, IN 46947-7931
Mailing address
1015 Michigan Ave
Logansport, IN 46947-1526
Phone (574) 722-5151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four County Comprehensive Mental Health Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342483200000",
"number": "1295080133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 MICHIGAN AVE",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "469471526",
"telephone_number": "574-722-5151",
"fax_number": "574-739-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2496 E COUNTY ROAD 125 N",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "469477931",
"telephone_number": "574-722-4042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGH",
"first_name": "JUSTIN",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-17",
"last_updated": "2012-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logansport, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.