Logan Shane Taylor, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

102 Center Park LN
Athens, GA 30605-4294

Phone

(229) 375-2426

NPI assigned

Jul 17, 2019

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625875200000",
    "number": "1306499413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 PICCADILLY SQ",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053044",
            "telephone_number": "229-375-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CENTER PARK LN",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306054294",
            "telephone_number": "229-375-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "LOGAN",
        "middle_name": "SHANE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2021-07-10",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon J Taylor, MD
• Bruce Taylor
• Christie Taylor
• Denise S. Taylor, D.O.
• Kay T Taylor, CRNA
• Mona Taylor, LCSW
• Neill Oliver Taylor, M.D.
• Sarah Grace Taylor
• Schenea Taylor, RN
• Teakay Merit, Inc.

• Athletic Trainer in Athens, GA
• Providers in Athens, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.