Individual provider Active NPI

Logan Christiansen, DPM

  • Podiatrist
  • Greeley, CO
National Provider Identifier
1467033134
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD.0000939 Issued in CO
Practice address
7251 W 20TH St Unit N
Greeley, CO 80634-4626
Phone
(303) 449-2000
Fax
(303) 449-9475
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 41000438A IN
Foot & Ankle Surgery Podiatrist 213ES0103X POD.0000939 CO
Podiatrist 213E00000X POD.0000939 CO Primary

Addresses

Primary practice location

7251 W 20TH St Unit N
Greeley, CO 80634-4626

Mailing address

1400 28TH St Ste 2
Boulder, CO 80303-1096
Phone (303) 449-2000

Other practice location 1

1400 28th St Ste 2
Boulder, CO 80303-1096
Phone (303) 449-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611002571 CO Practitioner - Podiatry 1153721170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7251 W 20TH St
Unit N
Greeley, CO 80634-4626
Phone (303) 449-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue31
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Care of Boulder County Podiatrist CurrentSince Jul 1, 2024 Accepting new patients
Foot and Ankle Care of Boulder County Podiatrist PastSince Jul 7, 2024 Accepting new patients

Locations

1400 28th St
Ste 2
Boulder, CO 80303
Phone (303) 449-2000

7251 W 20th St
Unit N1
Greeley, CO 80634
Phone (303) 449-2000

7251 W 20th St
Unit N
Greeley, CO 80634
Phone (303) 444-4141

Interoperability endpoints

  • Direct secure messaging: lchristiansen1143089@direct.trinity-health.org

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1467033134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 28TH ST STE 2",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031096",
            "telephone_number": "303-449-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7251 W 20TH ST UNIT N",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344626",
            "telephone_number": "303-449-2000",
            "fax_number": "303-449-9475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 28th St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803031096",
            "country_code": "US",
            "telephone_number": "303-449-2000",
            "fax_number": "303-449-9475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "LOGAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "41000438A",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "POD.0000939",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "POD.0000939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.