Logan Tyler Covington

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1601 Maple St
Carrollton, GA 30118-0001

Phone

(678) 839-6547

NPI assigned

Nov 20, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1366045387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 BRIAN DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712919476",
            "telephone_number": "318-789-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MAPLE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301180001",
            "telephone_number": "678-839-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVINGTON",
        "first_name": "LOGAN",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Carrollton",
            "affiliation": "N",
            "address_1": "1601 Maple St",
            "city": "Carrollton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301180001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melanie Miranda Corso, PT
• Ryan David Cortez, M.D.
• Cottage Landing, LLC
• Leslie Ann Cottrell, MD
• Shannon Vitale Couvreur, D.O.
• Vicki Diane Cowart
• Kendell Ranee Coyle
• Cpmsc Carrollton
• Jolyn B Crabb, ACNP
• Avian Mildree Craft

• Athletic Trainer in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.