Holly Maureen Logan, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G179028 Issued in IA

Practice address

600 W Sheridan Ave
Shenandoah, IA 51601-1708

Phone

(712) 246-0159

Fax

(712) 581-9084

NPI assigned

Apr 23, 2024

Last updated

Jul 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Connections IncGroup PAC ID 9234550419, 15 clinicians

Horizon Therapy Group LLCGroup PAC ID 0244243475, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Connections, Inc

  • Case Management Agency
  • Council Bluffs, IA
  • NPI 1740357300
  Medicare reassignment Care Compare group NPD
• Horizon Therapy Group, LLC

  • Counselor
  • Council Bluffs, IA
  • NPI 1457305518
  Medicare reassignment Care Compare group NPD
• Midwest Mental Health LLC

  dba Midwest Mental Health

  • Mental Health Counselor
  • Shenandoah, IA
  • NPI 1144695040
  Medicare reassignment NPD

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1295580041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 E NISHNA RD",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012541",
            "telephone_number": "712-313-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W SHERIDAN AVE",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516011708",
            "telephone_number": "712-246-0159",
            "fax_number": "712-581-9084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1977 G Ave",
            "address_purpose": "LOCATION",
            "city": "Red Oak",
            "state": "IA",
            "postal_code": "515664474",
            "country_code": "US",
            "telephone_number": "712-623-6349",
            "fax_number": "712-623-6047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "523 W Sheridan Ave",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "IA",
            "postal_code": "516011705",
            "country_code": "US",
            "telephone_number": "712-246-0159",
            "fax_number": "712-581-9084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "HOLLY",
        "middle_name": "MAUREEN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G179028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kleier, DDS
• Kelly Lynn Kline, FNP-C
• Logan J Kopf, CRNA
• Angela Sue Ledford, D.C
• Darci Lewis, PHARM.D, RPH
• Jennifer Ann Lundgren, PMHNP
• David Lutz, MD
• Angela Dawn Mace
• Martee R Macleod-Kozal, M.D.
• Carin Renee Mason, DC

• Psychiatric/Mental Health Nurse Practitioner in Shenandoah, IA
• Providers in Shenandoah, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.