Individual provider Active NPI

Logan Henry, PA-C

  • Physician Assistant
  • Muncy, PA
National Provider Identifier
1609545177
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062971 Issued in PA
Practice address
255 US Highway 220
Muncy, PA 17756-6561
Phone
(800) 230-4565
NPI assigned
Sep 8, 2021
Last updated
Dec 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X MA062971 PA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630002894 AZ Practitioner - Physician Assistant 4587053301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9762AZMDEmergency Medicine Physician
MA062971PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Outpatient Clinics, Inc. CurrentSince Jun 5, 2023 Accepting new patients
VHS Outpatient Clinics, Inc. CurrentSince Jun 5, 2023 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

  • Direct secure messaging: logan.henry.1@600.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1609545177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 US HIGHWAY 220",
            "city": "MUNCY",
            "state": "PA",
            "postal_code": "177566561",
            "telephone_number": "800-230-4565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Woodbine Ln",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178226561",
            "country_code": "US",
            "telephone_number": "570-271-6700",
            "fax_number": "570-214-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "LOGAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncy, PA

Sources for this page

Verify at the official NPI Registry.