NPIMap

Individual provider Active NPI

Logan Wolford, MD

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1558855098
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
63226 Issued in TN
Practice address
169 Ashley Ave
Charleston, SC 29425-8905
Phone
(843) 876-8023
NPI assigned
Jun 19, 2018
Last updated
May 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 52542 SC
Emergency Medicine Physician 207P00000X 63226 TN Primary

Addresses

Primary practice location

169 Ashley Ave
Charleston, SC 29425-8905

Mailing address

169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425
Phone (843) 876-8023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200812002726 SC Practitioner - Emergency Medicine 1153674965 Reassigns benefits to 3 organizations
I20210602003392 TN Practitioner - Emergency Medicine 1153674965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 797-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52542SCMDEmergency Medicine Physician
63226TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Jun 17, 2021 Accepting new patients
McLeod Health Cheraw CurrentSince Jul 18, 2020 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 1, 2023 Accepting new patients
McLeod Health Cheraw Emergency Medicine CurrentSince Jul 18, 2020 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Mar 1, 2022 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 1, 2023 Accepting new patients

Locations

169 Ashley Ave
Charleston, SC 29425
Phone (843) 792-4074

169 Ashley Ave
Rm 202
Charleston, SC 29425
Phone (843) 792-0192

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

110 Hospital Dr
Jefferson Cty, TN 37760
Phone (865) 471-2431

10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1558855098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-876-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-876-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFORD",
        "first_name": "LOGAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "52542",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "63226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.