Logan D Jones, D.O.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

58413 Issued in CO

Practice address

208 W Casablanca Ave BLDG 1400
Cannon AFB, NM 88103-5009

Phone

(575) 784-7801

NPI assigned

Apr 14, 2009

Last updated

Apr 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Occupational Medicine Physician
  • Aurora, CO
  • NPI 1497347603
  NPD (past)

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1558504068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 BIGHORN CT",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805503178",
            "telephone_number": "801-362-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W CASABLANCA AVE BLDG 1400",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "881035009",
            "telephone_number": "575-784-7801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12401 E 17th Ave Ste 783",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452548",
            "country_code": "US",
            "telephone_number": "855-945-3668",
            "fax_number": "720-848-7376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Main St",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805011406",
            "country_code": "US",
            "telephone_number": "970-237-8031",
            "fax_number": "970-237-8035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "LOGAN",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CO",
            "license": "58413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000193604",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Hurtt, MD
• Jose R Jasso Jr., MSW
• Martin Oleen Jensen, IDMT
• Jeremiah Edwin Johnson, R.D. MPH
• Griffon Jones, DPT
• Becky L Kaime, RPH
• Brandi Konieczynski
• Joseph Lee, PHARMD
• Stephanie Marie Lee
• Abbey Lindholm

• Occupational Medicine Physician in Cannon AFB, NM
• Providers in Cannon AFB, NM by specialty
• Occupational Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.