NPIMap

Individual provider Active NPI

Kyra Logan Nelson, PA-C

  • Physician Assistant
  • Nashville, TN
National Provider Identifier
1558863555
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5740 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-7201
Phone
(615) 322-3000
NPI assigned
Mar 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA11881 TX
Physician Assistant 363A00000X 5740 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-7201

Mailing address

3841 Green Hills Village Dr
Nashville, TN 37215-2691

Other practice location 1

1161 21st Ave S
Nashville, TN 37232-7201
Phone (615) 322-0648

Other practice location 2

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (469) 419-9606

Other names 1

  • Kyra Nicole Logan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knelson792942@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, 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
I20180328002793 TX Practitioner - Physician Assistant 2365704574 Reassigns benefits to 2 organizations
I20231220002665 TN Practitioner - Physician Assistant 2365704574 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Baylor College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

1301 Medical Ctr Dr
Nashville, TN 37232-0028
Phone (615) 322-5000

719 Thompson LN
Nashville, TN 37204-3609
Phone (615) 322-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5740TNMDClinical Social Worker
PA11881TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center Diagnostic Radiology CurrentSince Jan 1, 2024 Accepting new patients
Medhealth CurrentSince Aug 1, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 4, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 4, 2021 Accepting new patients
Tuhc Radiology Group LLC Diagnostic Radiology Past Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

919 Murfreesboro Rd
Franklin, TN 37064
Phone (615) 791-7373

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

719 Thompson Ln
Ste 23300
Nashville, TN 37204
Phone (615) 936-3606

3841 Green Hills Village Dr
Nashville, TN 37215
Phone (615) 322-7127

221 W Colorado Blvd
Ste 425
Dallas, TX 75208
Phone (214) 942-3100

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: knelson792942@direct.vumc.org
  • Direct secure messaging: klogan324992@direct.sw.org

Organizations & group practices 10

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 4

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": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1558863555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372327201",
            "telephone_number": "615-322-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1161 21st Ave S",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372327201",
            "country_code": "US",
            "telephone_number": "615-322-0648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5200 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357709",
            "country_code": "US",
            "telephone_number": "469-419-9606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KYRA",
        "middle_name": "LOGAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA11881",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knelson792942@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372327201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KYRA",
            "last_name": "LOGAN",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.