Andrea F Logan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

21719 Issued in MS

Practice address

1129 Ocean Springs Rd
Ocean Springs, MS 39564-3421

Phone

(228) 818-5008

Fax

(228) 818-5012

NPI assigned

Jul 9, 2008

Last updated

Feb 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andreafykelogan@grh.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Singing River Gulfport

  dba Singing River Gulfport Ambulatory

  • Multi-Specialty Clinic/Center
  • Gulfport, MS
  • NPI 1861010159
  Medicare reassignment NPD
• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937
  Medicare reassignment NPD
• Andrea Logan MD

  • Pediatrics Physician
  • Ocean Springs, MS
  • NPI 1336598028
  NPD (past) Authorized official
• George County Hospital

  • Rural Acute Care Hospital
  • Lucedale, MS
  • NPI 1023074028
  NPD
• Singing River Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1487327193
  NPD
• Singing River Health System

  dba Inpatient Physician Services

  • Internal Medicine Physician
  • Pascagoula, MS
  • NPI 1134283419
  NPD

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1407019375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 OCEAN SPRINGS RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643421",
            "telephone_number": "228-818-5008",
            "fax_number": "228-818-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 OCEAN SPRINGS RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643421",
            "telephone_number": "228-818-5008",
            "fax_number": "228-818-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "ANDREA",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "AU5009697 1339",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "21719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08607835",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "21719",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• LKM Resources LLC
• Sarah Crews Sparks Lochren, PA-C
• Megan Elaine Lockley, LCSW
• Michael Jay Loebenberg, M.D.
• Catherine Lofton
• Lori M. Kilpatrick Speech and Feeding Therapy
• Carly Rachael Lott, COTA/L
• Madison Waller Louviere
• William Russell Love Sr., R.PH
• Loves Pharmacy, Inc

• Pediatrics Physician in Ocean Springs, MS
• Providers in Ocean Springs, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.