Garrett Logan, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTH-009747 Issued in AZ

Practice address

16844 N 59TH Ave
Glendale, AZ 85306-1118

Phone

(480) 787-5387

Fax

(623) 209-8822

NPI assigned

Sep 6, 2024

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1629803879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 W INDIAN SCHOOL RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850372388",
            "telephone_number": "480-787-5387",
            "fax_number": "623-232-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16844 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061118",
            "telephone_number": "480-787-5387",
            "fax_number": "623-209-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "GARRETT",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.