Logan Chandler Blake, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH10812 Issued in AL

Practice address

1111 Knight St SE
Decatur, AL 35601-6501

Phone

(256) 973-1552

Fax

(256) 973-1553

NPI assigned

May 23, 2022

Last updated

Dec 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Refine PT and Performance - North Alabama LLCGroup PAC ID 7810387909, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Refine PT and Performance - North Alabama LLC

  • Physical Therapist
  • Decatur, AL
  • NPI 1689346405
  Medicare reassignment Care Compare group NPD
• Refine PT and Performance LLC

  • Physical Therapist
  • Daphne, AL
  • NPI 1568930907
  Medicare reassignment NPD

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1326786187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S FLORIDA ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366061927",
            "telephone_number": "251-501-2700",
            "fax_number": "251-501-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 KNIGHT ST SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016501",
            "telephone_number": "256-973-1552",
            "fax_number": "256-973-1553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 S Florida St",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366061927",
            "country_code": "US",
            "telephone_number": "251-501-2700",
            "fax_number": "251-501-2701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "LOGAN",
        "middle_name": "CHANDLER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH10812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "logan@refineptp.com",
            "affiliation": "N",
            "endpointDescription": "Direct Provider Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "108 S Florida St",
            "city": "Mobile",
            "state": "AL",
            "country_code": "US",
            "postal_code": "366061927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barry G. Black, CRNA
• Caleb Blackman, LGSW
• Candice Nicole Blackwood, FNP
• Paige Blackwood, RN
• Kaitlyn Blagburn, BA
• Morgan Taylor Blake, PT, DPT
• De Etta Lynn Blakenship
• Heather Shaw Blankenship, NP
• Hannah Blevins, PHARMD
• Casey Bodkin

• Physical Therapist in Decatur, AL
• Providers in Decatur, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.