Active NPI
Logan Anderson
- Pharmacist
- Atlanta, GA
National Provider Identifier
1497635239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH035632
- Practice address
- 2859 Fairlane Dr
Atlanta, GA 30340-3229 - Phone
- (478) 952-5923
- NPI assigned
- Sep 3, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH035632 | GA | Primary |
Addresses
Primary practice location
2859 Fairlane Dr
Atlanta, GA 30340-3229
Mailing address
118 Country LN
Kathleen, GA 31047-2541
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH035632 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756857600000",
"number": "1497635239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 COUNTRY LN",
"city": "KATHLEEN",
"state": "GA",
"postal_code": "310472541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2859 FAIRLANE DR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303403229",
"telephone_number": "478-952-5923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "LOGAN",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2025-09-03",
"last_updated": "2025-09-03",
"certification_date": "2025-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH035632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.