Logan Henry, PA-C
Individual provider Active NPI Physician Assistant · Muncy, PA
NPI 1609545177 · NPPES record last updated Dec 22, 2021
Key facts
- NPI
- 1609545177
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- MA062971 (PA)
- Practice address
- 255 US Highway 220
Muncy, PA 17756-6561 - Phone
- (800) 230-4565
- NPI assigned
- Sep 8, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- VHS Outpatient Clinics Inc
Practice addresses (Care Compare)
1840 S Stapley Dr
Suite 137
Mesa, AZ 85204-6683
Phone (480) 558-3744
18701 N 67TH Ave
Glendale, AZ 85308-7100
Phone (623) 561-1000
5130 W Baseline Rd
Suite 102
Laveen, AZ 85339-2984
Phone (602) 237-0039
6320 W Union Hills Dr
Suite 1800
Glendale, AZ 85308-1372
Phone (480) 372-2117
Hospital & facility affiliations
- Abrazo Arrowhead Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230630002894 | AZ | Practitioner - Physician Assistant | 4587053301 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9762 | AZ | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| VHS Outpatient Clinics, Inc. | Current |
Accepting new patients |
Locations
18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000
6320 W Union Hills Dr
Ste 1800
Glendale, AZ 85308
Phone (480) 420-0749
5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039
3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000
8630 E Via de Ventura
Ste 201
Scottsdale, AZ 85258
Phone (214) 556-3227
Interoperability endpoints
- logan.henry.1@600.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | MA062971 | PA | Yes |
Addresses
Primary practice location
255 US Highway 220
Muncy, PA 17756-6561
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
Other practice location 1
16 Woodbine Ln
Danville, PA 17822-6561
Phone (570) 271-6700
Other providers in Muncy, PA
- Sherry L Heckman
- Robert James Heckrote
- Jennifer Caitlin Heikkinen
- Leslie K Heiney
- Dwight Heller
- Jacob James Herron
- Kaitlyn Hill
- Elizabeth J Hotaling
- Robert Hynick
- Hugh David Johnson
All providers in Muncy, PA · Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.