Individual provider Active NPI

Michael B Loggan, M.D.

  • Pulmonary Disease Physician
  • Liberty, MO
National Provider Identifier
1336128552
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MDR7E84 Issued in MO
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

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
13710013OtherMOBCBS
202556403MedicaidMO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817001478 MO Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Sleep Medicine 0840347597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
University of Kansas School of Med (KC/Wich/Sal), 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

1155 W Parkview St
Suite 2B
Bolivar, MO 65613-7800
Phone (417) 328-6055

Hospital & facility affiliations

  • Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195
  • Cox Medical Centers Hospital, Springfield, MO, CCN 260040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MDR7E84MOMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Healthcare CurrentSince Sep 1, 2020 Accepting new patients
Citizens Memorial Healthcare CurrentSince Sep 1, 2020 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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.