Active NPI
Michael B Loggan, M.D.
- Pulmonary Disease Physician
- Liberty, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MDR7E84
- Practice address
- 2521 Glenn Hendren Dr
Suite 402
Liberty, MO 64068 - Phone
- (816) 781-8445
- Fax
- (816) 781-8413
- NPI assigned
- Jan 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | MDR7E84 | MO | Primary |
Addresses
Primary practice location
2521 Glenn Hendren Dr
Suite 402
Liberty, MO 64068
Mailing address
2521 Glenn Hendren Dr
Suite 402
Liberty, MO 64068-3388
Phone (816) 781-8445
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13710013 | Other | MO | BCBS |
| 202556403 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1155 W Parkview St
Suite 2B
Bolivar, MO 65613-7800
Phone (417) 328-6055
Hospital & facility affiliations
- Citizens Memorial Hospital
- Cox Medical Centers
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDR7E84 | MO | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citizens Memorial Healthcare | Current | Accepting new patients | |
| Citizens Memorial Healthcare | Current | Accepting new patients |
Locations
1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000
1165 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 777-6246
1155 W Parkview St
Ste 2B
Bolivar, MO 65613
Phone (417) 328-6055
Organizations & group practices 2
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.
-
- Surgery Physician
- Bolivar, MO
- NPI 1568566131
-
- Rural Health Clinic/Center
- Willard, MO
- NPI 1568127397
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bolivar, MO
- NPI 1003981549
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1093740128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1336128552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2521 GLENN HENDREN DR",
"address_2": "SUITE 402",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640683388",
"telephone_number": "816-781-8445",
"fax_number": "816-781-8413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2521 GLENN HENDREN DR",
"address_2": "SUITE 402",
"city": "LIBERTY",
"state": "MO",
"postal_code": "64068",
"telephone_number": "816-781-8445",
"fax_number": "816-781-8413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGGAN",
"first_name": "MICHAEL",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-16",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MO",
"license": "MDR7E84",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "13710013",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202556403",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Liberty, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.
- 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.