NPIMap

Individual provider Active NPI

Logan Dege Pearl, DNP

  • Family Nurse Practitioner
  • St Johnsbury, VT
National Provider Identifier
1447735436
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101.0134212 Issued in VT
Practice address
185 Sherman Dr
St Johnsbury, VT 05819-9811
Phone
(802) 748-5041
NPI assigned
Sep 26, 2018
Last updated
Sep 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 101.0134212 VT Primary

Addresses

Primary practice location

185 Sherman Dr
St Johnsbury, VT 05819-9811

Mailing address

165 Sherman Dr
St Johnsbury, VT 05819-9811
Phone (802) 748-9405

Other names 1

  • Logan Pearl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105002570 VT Practitioner - Nurse Practitioner 9739432972 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Vermont Regional Hospital IncGroup PAC ID 3678481405, shared by 15 NPIs, 104 clinicians

Practice addresses (Care Compare)

1315 Hospital Dr
Saint Johnsbury, VT 05819-9210
Phone (802) 748-8141

195 Industrial Pkwy
Lyndonville, VT 05851-4511
Phone (802) 748-9501

457 Railroad St
Suite 2
Saint Johnsbury, VT 05819-1643
Phone 80274894051599

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
101.0134212VTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Counties Health Care, Inc. CurrentSince Nov 27, 2018 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northern Counties Health Care Inc CurrentSince Nov 27, 2018 Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Nov 16, 2021 Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Nov 1, 2021 Accepting new patients
Northeastern Vermont Regional Hospital Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc. Past Accepting new patients

Locations

26 Cedar Ln
Danville, VT 05828
Phone (802) 684-2275

195 Industrial Pkwy
Lyndonville, VT 05851

195 Industrial Pkwy
#1
Lyndonville, VT 05851

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

165 Sherman Dr
St Johnsbury, VT 05819
Phone (802) 748-9405

185 Sherman Dr
St Johnsbury, VT 05819
Phone (802) 695-2512

457 Railroad St
#2
St Johnsbury, VT 05819
Phone (802) 633-6351

Interoperability endpoints

  • Direct secure messaging: logan.pearl.1@28542.direct.athenahealth.com

Organizations & group practices 11

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1447735436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SHERMAN DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199811",
            "telephone_number": "802-748-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 SHERMAN DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199811",
            "telephone_number": "802-748-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGE PEARL",
        "first_name": "LOGAN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0134212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOGAN",
            "last_name": "PEARL",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.