NPIMap

Organization Active NPI

Logan General Hospital LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Logan, WV
National Provider Identifier
1295789675
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
LOGAN GENERAL HOSPITAL LLC
Practice address
20 Hospital Dr
Logan, WV 25601-3452
Phone
(304) 831-1101
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

20 Hospital Dr
Logan, WV 25601-3452

Mailing address

680 S 4TH St
Louisville, KY 40202-2407
Phone (502) 596-6063

Other names 1

  • Logan Regional Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lggh@direct.loganregionalmedical.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030306000014 WV Part A Provider - Hospital 9537078977 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chapmanville, WV; Logan, WV
O20081202000722 WV Part A Provider - Hospital 9537078977 Practice locations: Logan, WV

Hospital certification: CCN 510048

Legal name
LOGAN GENERAL HOSPITAL LLC
Doing business as
LOGAN REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Apr 1, 1969
Last certification
Nov 8, 2012
Beds
140
Ownership / control type
Private (for profit)
Most recent change of ownership
Dec 1, 2002 (1 total)
Organization structure
LLCProprietary
Incorporated
Aug 23, 2002 in DE
Enrollment address
20 Hospital Dr
Logan, WV 25601-3452
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 51U048

Legal name
LOGAN GENERAL HOSPITAL LLC
Doing business as
LOGAN REGIONAL MEDICAL CENTER
Organization structure
LLCProprietary
Incorporated
Aug 23, 2002 in DE
Enrollment address
20 Hospital Drive
Logan, WV 25601-3452
Hospital Swing-Bed Unit
Hospital subgroups
General, Swing-bed approved, Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Logan Regional Medical CenterCCN 510048
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kindred Healthcare Operating LLC Organization, Louisville, KY LLC, For-profit Operational/Managerial Control Dec 23, 2021 100%
Operational/Managerial Control Jan 21, 2022 100%
Jacquelyn Joy Davis Individual W-2 Managing EmployeeChain Home Office Admin Dec 16, 2023
Scott Graeser Individual Corporate OfficerVice President, Treasurer Aug 19, 2022
Dana M Rock Individual Corporate OfficerAssistant Administrator Dec 9, 2024
Johnetta M Traylor Individual Corporate OfficerAdministrator Dec 9, 2024
Russell Pigg Individual Corporate OfficerPresident May 14, 2025
Corporate OfficerPresident May 15, 2025
Knight Health Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Michael Joseph Bean Individual Corporate OfficerVice President, Tax Jan 21, 2022
Knight Healthcare New-B, LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Dec 23, 2021 100%
Knight Health II, LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Alan Wenk Individual Corporate OfficerChief Financial Officer Mar 17, 2025

Facilities with the same owner 97

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 97

Practitioners & affiliated clinicians

Affiliated clinicians 207

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 207

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1295789675",
    "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": "20 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013452",
            "telephone_number": "304-831-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN GENERAL HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lggh@direct.loganregionalmedical.net",
            "affiliation": "N",
            "address_1": "20 Hospital Dr",
            "city": "Logan",
            "state": "WV",
            "country_code": "US",
            "postal_code": "256013452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Logan Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Logan Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logan, WV

Sources for this page

Verify at the official NPI Registry.