Individual provider Active NPI

Logan Kay, DMD

  • Dentist
  • Burley, ID
National Provider Identifier
1316322167
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D4672 Issued in ID
Practice address
1309 Bennett Ave
Burley, ID 83318-2676
Phone
(208) 732-7447
NPI assigned
Jul 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D4672 ID Primary

Addresses

Primary practice location

1309 Bennett Ave
Burley, ID 83318-2676

Mailing address

794 Eastland Dr
Twin Falls, ID 83301-6856
Phone (208) 734-3312

Other practice location 1

826 Esatland Dr
Twin Falls, ID 83301
Phone (208) 732-7447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170117001296 ID Order and Referring Only - DentistPractitioner - Dentist 0941582506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D4672IDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services Corporation Dentist Past Accepting new patients
Family Health Services Corporation Dentist Past Accepting new patients
Family Health Services Corporation Dentist Past Accepting new patients
Family Health Services Corporation Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: logan.kay.p1@direct.fhsid.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1316322167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 BENNETT AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182676",
            "telephone_number": "208-732-7447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "826 Esatland Dr",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "83301",
            "country_code": "US",
            "telephone_number": "208-732-7447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAY",
        "first_name": "LOGAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-22",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

Verify at the official NPI Registry.