Individual provider Active NPI

Logan Gregory Calvert, DC

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1407568975
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010874 Issued in GA
Practice address
3625 Dallas Hwy SW Ste 850
Marietta, GA 30064-5925
Phone
(678) 571-1203
NPI assigned
Dec 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010874 GA Primary

Addresses

Primary practice location

3625 Dallas Hwy SW Ste 850
Marietta, GA 30064-5925

Mailing address

3625 Dallas Hwy SW Ste 850
Marietta, GA 30064-5925
Phone (678) 571-1203

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

LicenseStateTypeSpecialty
CHIR010874GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
100 Percent Chiropractic Foster LLC Chiropractor CurrentSince Dec 18, 2022 Accepting new patients

Locations

3625 Dallas Hwy SW
Ste 850
Marietta, GA 30064
Phone (510) 717-0225

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1407568975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 DALLAS HWY SW STE 850",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645925",
            "telephone_number": "678-571-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 DALLAS HWY SW STE 850",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645925",
            "telephone_number": "678-571-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALVERT",
        "first_name": "LOGAN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.