Individual provider Active NPI

Logan Lloyd Warner, DO

  • Family Medicine Physician
  • Quincy, IL
National Provider Identifier
1548829591
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125.074865 Issued in IL
Practice address
612 N 11TH St
Quincy, IL 62301-2662
Phone
(217) 224-9484
Fax
(217) 224-7950
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.074865 IL Primary

Addresses

Primary practice location

612 N 11TH St
Quincy, IL 62301-2662

Mailing address

612 N 11TH St
Quincy, IL 62301-2662
Phone (217) 224-9484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727000788 IL Practitioner - Family Practice 2567797871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125.074865ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jul 30, 2022 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jul 30, 2022 Accepting new patients

Locations

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

Interoperability endpoints

  • Direct secure messaging: lwarner894999@direct.unitypoint.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1548829591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N 11TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012662",
            "telephone_number": "217-224-9484",
            "fax_number": "217-224-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N 11TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012662",
            "telephone_number": "217-224-9484",
            "fax_number": "217-224-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "LOGAN",
        "middle_name": "LLOYD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.074865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.