Active NPI
Logan Samuel, DPT
- Physical Therapist
- Metairie, LA
National Provider Identifier
1386273720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 09979
- Practice address
- 3750 Veterans Memorial Blvd Ste 60
Metairie, LA 70002-5825 - Phone
- (504) 900-1411
- NPI assigned
- Apr 7, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 09979 | LA | Primary |
Addresses
Primary practice location
3750 Veterans Memorial Blvd Ste 60
Metairie, LA 70002-5825
Mailing address
6569 Wuerpel St
New Orleans, LA 70124-2252
Other practice location 1
1100 Circle 75 Parkway Ste 1400 30339
Atlanta, GA 30339
Phone (678) 403-3555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09979 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586217600000",
"number": "1386273720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6569 WUERPEL ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701242252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 VETERANS MEMORIAL BLVD STE 60",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700025825",
"telephone_number": "504-900-1411"
}
],
"practiceLocations": [
{
"address_1": "1100 Circle 75 Parkway Ste 1400 30339",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "30339",
"country_code": "US",
"telephone_number": "678-403-3555",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAMUEL",
"first_name": "LOGAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-07",
"last_updated": "2020-04-07",
"certification_date": "2020-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "09979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.