Logan General Hospital LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

LOGAN GENERAL HOSPITAL LLC

Practice address

38 Hospital Dr Ste 1a
Logan, WV 25601-3452

Phone

(304) 831-1892

Fax

(304) 831-1477

NPI assigned

Jul 14, 2022

Organization subpart

No

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

Authorized official

Name

Johnetta Traylor

Title

Ao

Phone

(502) 596-6063

Specialties & licenses 1

Addresses

Other names 1

• Logan Regional Primary Care - Logan Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Logan General Hospital LLC

  • Rural Health Clinic/Center
  • Chapmanville, WV
  • NPI 1023742053

  O20031217001124

  Same enrollment
• Logan General Hospital LLC

  • Rural Health Clinic/Center
  • Logan, WV
  • NPI 1255064531

  O20031217001124

  Same enrollment
• Logan General Hospital LLC

  • Podiatrist
  • Logan, WV
  • NPI 1720032105

  O20031217001124

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas C Vance, PA-C

  • Physician Assistant
  • Madison, WV
  • NPI 1528007705
  NPD

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1558095588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 HOSPITAL DR STE 1A",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013452",
            "telephone_number": "304-831-1892",
            "fax_number": "304-831-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN GENERAL HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan Regional Primary Care - Logan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Logan Family Care Center LLC
• Logan Family Health
• Logan Foot & Ankle Center
• Logan General Hospital LLC
• Logan General Hospital LLC
• Logan General Hospital LLC
• Logan General Hospital LLC
• Logan General Hospital LLC
• Logan Hematology-Oncology Inc
• Logan Internal Medicine Group

• Rural Health Clinic/Center in Logan, WV
• Providers in Logan, WV by specialty
• Rural Health Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.