NPIMap

Organization Active NPI

Logan Physician Practice LLC

Doing business as Logan Primary Care - Elkton

  • Rural Health Clinic/Center
  • Elkton, KY
National Provider Identifier
1427720994
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LOGAN PHYSICIAN PRACTICE LLC
Doing business as
Logan Primary Care - Elkton
Practice address
118 S Main St
Elkton, KY 42220-8863
Phone
(270) 265-5023
Fax
(270) 265-5026
NPI assigned
Oct 1, 2021
Last updated
Jul 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Kathy J Teague
Title
Vice President and Corp Secretary
Phone
(629) 253-5121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

118 S Main St
Elkton, KY 42220-8863

Mailing address

680 S 4TH St
Louisville, KY 40202-2407
Phone (502) 596-7300

Other names 1

  • Logan Primary Care - Elkton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Logan Physician Practic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1427720994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S MAIN ST",
            "city": "ELKTON",
            "state": "KY",
            "postal_code": "422208863",
            "telephone_number": "270-265-5023",
            "fax_number": "270-265-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN PHYSICIAN PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT AND CORP SECRETARY",
        "authorized_official_telephone_number": "629-253-5121"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan Primary Care - Elkton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Logan Primary Care - Elkton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.