Active NPI
Denise Logan, MS RD LD
- Registered Dietitian
- Loris, SC
National Provider Identifier
1427464247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 329
- Practice address
- 3811 Walnut St
Loris, SC 29569 - Phone
- (843) 756-4027
- Fax
- (843) 756-4039
- NPI assigned
- Jul 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 329 | SC | Primary |
Addresses
Primary practice location
3811 Walnut St
Loris, SC 29569
Mailing address
3811 Walnut St
Loris Health Dept
Loris, SC 29569
Phone (843) 756-4027
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 329 | SC | MD | Genetic Counselor (M.S.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404259200000",
"number": "1427464247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3811 WALNUT ST",
"address_2": "LORIS HEALTH DEPT",
"city": "LORIS",
"state": "SC",
"postal_code": "29569",
"telephone_number": "843-756-4027",
"fax_number": "843-756-4039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3811 WALNUT ST",
"city": "LORIS",
"state": "SC",
"postal_code": "29569",
"telephone_number": "843-756-4027",
"fax_number": "843-756-4039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "MS RD LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-02",
"last_updated": "2014-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loris, SC
- Little River Medical Center, Inc.
- Little River Medical Center, Inc.
- Little River Medical Center, Inc.
- Little River Medical Center, Inc.
- Alexander C Logan III, MD
- John C Lohlun, MD
- Loris Adult Day Care, LLC
- Loris Anesthesia and Pain Treatment, PLLC
- Loris Community Hospital District (Loris Extended Care Center)
- Loris Community Hospital District (Loris Healthcare System)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.