Active NPI
Donald R Logan, MD
- Body Imaging Physician
- Bedford, NH
National Provider Identifier
1568426385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- License
- 10868
- Practice address
- 703 Riverway PL
Bedford, NH 03110-6768 - Phone
- (603) 668-7096
- Fax
- (603) 669-6944
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 10868 | NH | Primary |
Addresses
Primary practice location
703 Riverway PL
Bedford, NH 03110-6768
Mailing address
703 Riverway PL
Bedford, NH 03110-6768
Phone (603) 668-7096
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01Y002303 NH05 | Other | NH | ANTHEM-MCH TAX ID |
| 01Y002303NH02 | Other | NH | BLUE CROSS |
| 2285319 | Other | NH | AETNA |
| 010868 | Other | NH | TUFTS |
| 294662 | Other | NH | CIGNA |
| 30200557 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568426385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 RIVERWAY PL",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106768",
"telephone_number": "603-668-7096",
"fax_number": "603-669-6944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 RIVERWAY PL",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106768",
"telephone_number": "603-668-7096",
"fax_number": "603-669-6944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "DONALD",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "NH",
"license": "10868",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM-MCH TAX ID",
"identifier": "01Y002303 NH05",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "01Y002303NH02",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2285319",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "010868",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "294662",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30200557",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bedford, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.