Kimberly Michelle Logan

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

Practice address

8848 Red Oak Blvd Ste Aa
Charlotte, NC 28217-5595

Phone

(980) 422-5887

NPI assigned

Jun 13, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Speech Tactics, PC

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1861736308
  NPD (past)

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1578056594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12534 SHELLY PINES DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621030",
            "telephone_number": "828-234-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8848 RED OAK BLVD STE AA",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282175595",
            "telephone_number": "980-422-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Logan
• Diashanna Yvette Logan
• Jada Logan
• Jaisen Logan
• Keith Logan, MD
• Matthew David Logan, DO
• Oran Franklin Logan III, MD
• Sandra L Logan, MA MED LPC
• Sheryl E Logan, NP
• Taylor Logan

• Speech-Language Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Speech-Language Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.