Logan Hospital and Medical Center Authority

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

2267 Issued in OK

Legal business name

LOGAN HOSPITAL AND MEDICAL CENTER AUTHORITY

Doing business as

Center for Internal Medicine and Pediatrics - Crescent

Practice address

400 S Grand
Crescent, OK 73028

Phone

(405) 969-2818

NPI assigned

Jul 13, 2005

Organization subpart

No

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

Authorized official

Name

Steve Rowley

Title

Ceo

Phone

(405) 260-4191

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Center for Internal Medicine and Pediatrics - Crescent Doing business as

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1497753487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 258",
            "city": "CRESCENT",
            "state": "OK",
            "postal_code": "730280258",
            "telephone_number": "405-969-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S GRAND",
            "city": "CRESCENT",
            "state": "OK",
            "postal_code": "73028",
            "telephone_number": "405-969-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN HOSPITAL AND MEDICAL CENTER AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "ROWLEY",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-260-4191"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "OK",
            "license": "2267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD8588",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Internal Medicine and Pediatrics - Crescent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon Lee Dunn, DNP, APRN-CNP, FNP-C
• Katrina House
• Jocelyn Janea Humphrey, M.S. CCC-SLP
• Dana K Larue
• Kyle N Lipke, PA
• Logsdon Lotz Drug Inc
• Ltcnp
• Tabetha Nicole Mathiesen, MS CCC-SLP
• Theresa Lynn McCartney
• Mercy Hospital Logan County, Inc

• Rural Health Clinic/Center in Crescent, OK
• Providers in Crescent, OK by specialty
• Rural Health Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.