Individual provider Active NPI

Ryan Logan, APRN

  • Family Nurse Practitioner
  • Erie, PA
National Provider Identifier
1457130775
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP028302 Issued in PA
Practice address
1645 W 8TH St
Erie, PA 16505-5007
Phone
(814) 864-9994
NPI assigned
Sep 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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 SP028302 PA Primary

Addresses

Primary practice location

1645 W 8TH St
Erie, PA 16505-5007

Mailing address

3536 Hereford Rd
Erie, PA 16510-2451
Phone (814) 323-3299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108006214 PA Practitioner - Nurse Practitioner 0749631356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1645 W 8TH St
Suite 200
Erie, PA 16505-5007
Phone 8148649994339

Hospital & facility affiliations

  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP028302PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose and Throat Specialists of Northwestern Pennsylvania CurrentSince Jan 2, 2024 Accepting new patients
Ear Nose and Throat Specialists of Northwestern Pennsylvania PastSince Jan 2, 2024 Accepting new patients

Locations

1645 W 8th St
#200
Erie, PA 16505
Phone (814) 864-9994

1645 W 8th St
Ste 200
Erie, PA 16505
Phone (814) 864-9994

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1457130775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 HEREFORD RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165102451",
            "telephone_number": "814-323-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W 8TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165055007",
            "telephone_number": "814-864-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP028302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.