Individual provider Active NPI

Matthew David Logan, DO

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1568040947
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2025-02044 Issued in NC
Practice address
10635 Park Rd Ste I
Charlotte, NC 28210-8408
Phone
(704) 495-6334
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2025-02044 NC Primary

Addresses

Primary practice location

10635 Park Rd Ste I
Charlotte, NC 28210-8408

Mailing address

5960 Fairview Rd Ste 500
Charlotte, NC 28210-3113
Phone (704) 495-6334

Other practice location 1

502 W Highland Blvd
Inverness, FL 34452-4720
Phone (352) 726-1551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250725002316 NC Practitioner - Internal Medicine 7416302021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tryon Medical Partners, PLLCGroup PAC ID 7113277971, 139 clinicians

Practice addresses (Care Compare)

201 S College St
FL 12
Charlotte, NC 28244-0002
Phone (704) 495-6334

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025-02044NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tryon Medical Partners, PLLC Internal Medicine CurrentSince Aug 18, 2025 Accepting new patients

Locations

10635 Park Rd
Ste I
Charlotte, NC 28210
Phone (704) 495-6025

5960 Fairview Rd
Ste 500
Charlotte, NC 28210

Interoperability endpoints

  • Direct secure messaging: matthew.logan.1@17847.direct.athenahealth.com
  • Direct secure messaging: matthew.logan@hca4.eclinicaldirectplus.com

Organizations & group practices 1

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1568040947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5960 FAIRVIEW RD STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103113",
            "telephone_number": "704-495-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10635 PARK RD STE I",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108408",
            "telephone_number": "704-495-6334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 W Highland Blvd",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344524720",
            "country_code": "US",
            "telephone_number": "352-726-1551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2025-02044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.