Active NPI
Jennifer Joy Logan, COTA
- Occupational Therapy Assistant
- Bel Aire, KS
National Provider Identifier
1578871836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 18-00737
- Practice address
- 6700 E 45TH St N
Bel Aire, KS 67226-8817 - Phone
- (316) 744-4109
- NPI assigned
- Sep 21, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 18-00737 | KS | Primary |
Addresses
Primary practice location
6700 E 45TH St N
Bel Aire, KS 67226-8817
Mailing address
159 Lioba Dr
Andover, KS 67002-9764
Phone (316) 259-0765
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-00737 | KS | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285027200000",
"number": "1578871836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 LIOBA DR",
"city": "ANDOVER",
"state": "KS",
"postal_code": "670029764",
"telephone_number": "316-259-0765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 E 45TH ST N",
"city": "BEL AIRE",
"state": "KS",
"postal_code": "672268817",
"telephone_number": "316-744-4109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "JENNIFER",
"middle_name": "JOY",
"name_prefix": "Miss",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-21",
"last_updated": "2010-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "KS",
"license": "18-00737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bel Aire, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.