Active NPI
Logansport Clinic for Women
- Obstetrics & Gynecology Physician
- Logansport, IN
National Provider Identifier
1376767178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- LOGANSPORT CLINIC FOR WOMEN
- Doing business as
- Women's Health Center of Logansport
- Practice address
- 1025 Michigan Ave
Suite 115
Logansport, IN 46947-1593 - Phone
- (574) 722-3566
- Fax
- (574) 753-6118
- NPI assigned
- Apr 12, 2007
- Organization subpart
- Yes
- Parent organization
- MEMORIAL HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Sandra M. Elliot, CHC
- Title
- Corporate Compliance Officer
- Phone
- (574) 753-1767
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | IN | Primary |
Addresses
Primary practice location
1025 Michigan Ave
Suite 115
Logansport, IN 46947-1593
Mailing address
1025 Michigan Ave
Suite 115
Logansport, IN 46947-1593
Phone (574) 722-3566
Other names 1
- Women's Health Center of Logansport
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0358780 | Parkview Logansport Hospital Women'S Health Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider Directory- Part of
- Logansport Memorial Hos
Locations
1025 Michigan Ave
Ste 115
Logansport, IN 46947
Phone (574) 722-3566
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Logansport, IN
- NPI 1821058363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1207526400000",
"number": "1376767178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 MICHIGAN AVE",
"address_2": "SUITE 115",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "469471593",
"telephone_number": "574-722-3566",
"fax_number": "574-753-6118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 MICHIGAN AVE",
"address_2": "SUITE 115",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "469471593",
"telephone_number": "574-722-3566",
"fax_number": "574-753-6118"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOGANSPORT CLINIC FOR WOMEN",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MEMORIAL HOSPITAL",
"enumeration_date": "2007-04-12",
"last_updated": "2008-04-07",
"status": "A",
"authorized_official_last_name": "ELLIOT",
"authorized_official_first_name": "SANDRA",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "CORPORATE COMPLIANCE OFFICER",
"authorized_official_telephone_number": "574-753-1767",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "CHC"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "IN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Women's Health Center of Logansport",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Logansport, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.