Logan Deroin, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

535 N Locust Grove Rd Ste 170
Meridian, ID 83642-9379

Phone

(208) 917-2660

NPI assigned

Aug 16, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rock and Armor Physical Therapy and Sports Performance, LLC 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rock and Armor Physical Therapy and Sports Performance, LLC

  • Physical Therapist
  • Meridian, ID
  • NPI 1689089971

  ID, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1629624366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 N LOCUST GROVE RD STE 170",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429379",
            "telephone_number": "208-917-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 N LOCUST GROVE RD STE 170",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429379",
            "telephone_number": "208-917-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROIN",
        "first_name": "LOGAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Jordan Dennis, PHARMD
• Dental Care for Kids
• Dental Implant Solutions PLLC
• Derek Barnes DDS, LLC
• Susan M Derivas, CNP
• Julia Paige Derrick
• Sarah Desilva, PHARM D
• Gayle Jean Detweiler, P.A.
• Robyn R Develle, DC, NP-C
• John B Dever, MD

• All providers in Meridian, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.