Logan Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

BL005438 Issued in MI

Legal business name

LOGAN CHIROPRACTIC CENTER

Practice address

27104 Dequindre Rd
Warren, MI 48092-3537

Phone

(586) 751-1977

Fax

(586) 751-1929

NPI assigned

Jan 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bill Alan Logan, D.CNPI 1740203405

Title

Owner

Phone

(586) 751-1977

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Logan Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Logan Chiropractic Center

  • Clinic/Center
  • Warren, MI
  • NPI 1366858102
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bill Alan Logan, D.C.

  • Chiropractor
  • Warren, MI
  • NPI 1740203405
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511827200000",
    "number": "1629124326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27104 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480923537",
            "telephone_number": "586-751-1977",
            "fax_number": "586-751-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27104 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480923537",
            "telephone_number": "586-751-1977",
            "fax_number": "586-751-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-11-28",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "BILL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-751-1977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "BL005438",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "CS008620",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "950E001510",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4510951",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth R Lock, D.O.
• Elizabeth A. Locke Wisniewski, PT, DPT
• Kaelyn Reyon Lockridge
• Emma Lockwood, DC
• Logan Chiropractic Center
• Bill Alan Logan, D.C.
• Muamera Logo-Lojo, LMSW
• Merima Logo, LLMSW
• Ismira Lokmic
• Daniel Raymond Lomasney, PA-C

• Chiropractor in Warren, MI
• Providers in Warren, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.