Logan Nicole Thomas

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

30187 Issued in TN

Practice address

329 Wesley St
Johnson City, TN 37601-1772

Phone

(423) 631-0055

NPI assigned

Nov 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Logan Crouch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Kids First Children'S Urgent Care

  • Pediatrics Physician
  • Johnson City, TN
  • NPI 1255046090
  NPD

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1639835895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 EPPERSON ST",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373033478",
            "telephone_number": "423-745-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 WESLEY ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011772",
            "telephone_number": "423-631-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LOGAN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-11",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "30187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOGAN",
            "last_name": "CROUCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Candace Thomas, DO
• Cynde L Thomas, CRNA
• Cynthia Crews Thomas, D.O., M.P.H.
• Eapen Thomas, MD
• Lacinda R Thomas, LPC
• Matthew Shawn Thomas, DO
• Morgan Thomas, PHARMD
• Vinaya Ann Thomas
• Jefferson Thompson
• Julia E Thompson, PHD

• Pediatric Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.