Kevin Michael Logan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01052474A Issued in IN

Practice address

8499 Fishers Center Dr.
Fishers, IN 46038-2318

Phone

(317) 598-4325

Fax

(317) 598-4326

NPI assigned

May 10, 2007

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2013 through Apr 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  • Community/Retail Pharmacy
  • Indianapolis, IN
  • NPI 1194929646
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  • Psychiatry Physician
  • Indianapolis, IN
  • NPI 1689869893
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1639384183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8499 FISHERS CENTER DR.",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382318",
            "telephone_number": "317-598-4325",
            "fax_number": "317-598-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8499 FISHERS CENTER DR.",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382318",
            "telephone_number": "317-598-4325",
            "fax_number": "317-598-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01052474A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Littlefield
• Louie Cabe Liwanag
• Lloyd Podiatry Group Inc
• Alexa Renne Lockhart
• Michelle Loftin
• Leah Logan, MSOTR
• Keith W Logie, M.D.
• Chloe Catherine Long, OTR/L
• Harold O Longe, MD
• Peter Arnold Lopat, DC

• Internal Medicine Physician in Fishers, IN
• Providers in Fishers, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.