Cynthia A Logan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2016-01589 Issued in NC

Practice address

125 Vance Hill Dr
Mills River, NC 28759

Phone

(828) 891-7522

Fax

(828) 891-7523

NPI assigned

Jan 30, 2006

Last updated

Apr 15, 2019By 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 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Cardiovascular Disease Physician
  • Marion, VA
  • NPI 1326159567
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Neurological Surgery Physician
  • Abingdon, VA
  • NPI 1497057491
  NPD
• Medexpress Urgent Care, PC - Tennessee

  • Urgent Care Clinic/Center
  • Bristol, TN
  • NPI 1689931446
  NPD (past)
• St Charles Health Council Inc

  dba Coeburn Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Coeburn, VA
  • NPI 1942322003
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1306817259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1869",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287321869",
            "telephone_number": "828-687-5698",
            "fax_number": "828-650-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 VANCE HILL DR",
            "city": "MILLS RIVER",
            "state": "NC",
            "postal_code": "28759",
            "telephone_number": "828-891-7522",
            "fax_number": "828-891-7523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 Campus Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "24210",
            "country_code": "US",
            "telephone_number": "276-739-8010",
            "fax_number": "276-628-1410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24530 Falcon Place Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117665",
            "country_code": "US",
            "telephone_number": "276-619-0075",
            "fax_number": "276-619-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 Campus Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "24210",
            "country_code": "US",
            "telephone_number": "276-739-8010",
            "fax_number": "276-628-1410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101222161",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2016-01589",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "42113",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01081173",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306817259",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000080",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arnold Kozak, PH.D.
• Benajah Scott Lamm, PHARMD
• Christopher Lewis, PHARMD
• Light of Life Global Ministries (Light of Life Homes)
• Living Alchemy
• Laura Long, FNP-BC
• Christina Ai Martin, MD
• Mills River Family Chiropractic, PA
• Mills River Physical Therapy, Inc.
• Ann Fisher Moore, MA CCC SLP

• Family Medicine Physician in Mills River, NC
• Providers in Mills River, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.