Makenzie Rae Logan

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2018010907 Issued in NE

Practice address

1401 High School Dr
Bellevue, NE 68005-3274

Phone

(402) 293-4150

NPI assigned

Aug 13, 2018

Last updated

Aug 13, 2018By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1417436148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 ARBORETUM DR",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053501",
            "telephone_number": "402-293-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HIGH SCHOOL DR",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053274",
            "telephone_number": "402-293-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "MAKENZIE",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "2018010907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF ILLINOIS",
            "identifier": "TFZ826226512",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Ann Livingston
• Rebecca Loehr
• Tina Ann Loftus
• Jeffrey Logan
• Lee Quasia Logan
• Heaven Lee Logue
• Ronald L Loker, PA
• Vianey Del Carmen Lomeli Valdivia
• Ida Long
• Aarihanna Lakye Looney

• Speech-Language Pathologist in Bellevue, NE
• Providers in Bellevue, NE by specialty
• Speech-Language Pathologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.