Active NPI
Jonathan Scott Logan, DPM
- Podiatrist
- Willoughby, OH
National Provider Identifier
1457464927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 36-003242
- Practice address
- 35000 Kaiser CT
Willoughby, OH 44094-3382 - Phone
- (440) 269-4010
- NPI assigned
- Aug 17, 2006
- Last updated
- Apr 16, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 36-003242 | OH | Primary |
Addresses
Primary practice location
35000 Kaiser CT
Willoughby, OH 44094-3382
Mailing address
35000 Kaiser CT
Willoughby, OH 44094-3382
Phone (440) 269-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36-003242 | OH | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555372800000",
"number": "1457464927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35000 KAISER CT",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440943382",
"telephone_number": "440-269-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35000 KAISER CT",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440943382",
"telephone_number": "440-269-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "JONATHAN",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2019-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "OH",
"license": "36-003242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willoughby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.