Organization Active NPI

Logansport Clinic for Women

  • Obstetrics & Gynecology Physician
  • Logansport, IN
National Provider Identifier
1376767178
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
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 HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0358780Parkview Logansport Hospital Women'S Health Center1025 Michigan Ave Ste 115, Logansport, IN 46947Certificate of waiverAug 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.

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.

Verify at the official NPI Registry.