NPIMap

Organization Active NPI

Logan Pediatrics, PLLC

  • Pediatrics Physician
  • Russellville, KY
National Provider Identifier
1497867089
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
39621 Issued in KY
Legal business name
LOGAN PEDIATRICS, PLLC
Practice address
975 Hopkinsville Rd
Russellville, KY 42276-9774
Phone
(270) 726-1266
Fax
(270) 726-1961
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Varsha Humble, MD
Title
Owner
Phone
(270) 726-1266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 39621 KY Primary

Addresses

Primary practice location

975 Hopkinsville Rd
Russellville, KY 42276-9774

Mailing address

975 Hopkinsville Rd
Russellville, KY 42276-9774
Phone (270) 726-1266

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497867089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 HOPKINSVILLE RD",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422769774",
            "telephone_number": "270-726-1266",
            "fax_number": "270-726-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 HOPKINSVILLE RD",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422769774",
            "telephone_number": "270-726-1266",
            "fax_number": "270-726-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUMBLE",
        "authorized_official_first_name": "VARSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-726-1266",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "39621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.