Individual provider Active NPI

Celia W Logsdon, AU.D.

  • Audiologist
  • Gloucester, MA
National Provider Identifier
1629039151
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
430 Issued in MA
Practice address
1 Blackburn Dr
Gloucester, MA 01930-2237
Phone
(978) 283-6888
Fax
(978) 283-8655
NPI assigned
Apr 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 430 MA Primary

Addresses

Primary practice location

1 Blackburn Dr
Gloucester, MA 01930-2237

Mailing address

1 Blackburn Dr
Gloucester, MA 01930-2237
Phone (978) 283-6888

Other identifiers 1

IdentifierTypeStateIssuer
110062782AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091001000192 MA Practitioner - Qualified Audiologist 5193861300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hearing Services of Cape AnnGroup PAC ID 3577619824, 3 clinicians

Practice addresses (Care Compare)

1 Blackburn Dr
Gloucester, MA 01930-2237
Phone (978) 283-6888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
430MAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Services of Cape Ann Audiologist CurrentSince Jun 8, 2009 Accepting new patients

Locations

1 Blackburn Dr
Gloucester, MA 01930
Phone (978) 282-3698

1 Blackburn Dr
Ste 1
Gloucester, MA 01930

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1629039151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLACKBURN DR",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019302237",
            "telephone_number": "978-283-6888",
            "fax_number": "978-283-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACKBURN DR",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019302237",
            "telephone_number": "978-283-6888",
            "fax_number": "978-283-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGSDON",
        "first_name": "CELIA",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-02",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110062782A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.