Logan McKenzie Widvey, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2427 Issued in SD

Practice address

801 E Sioux Ave
Pierre, SD 57501-3323

Phone

(605) 224-3162

NPI assigned

Dec 8, 2023

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 Gesinger Former name

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera St MarysGroup PAC ID 0143134965, 97 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Avera St Marys

  • General Acute Care Hospital
  • Pierre, SD
  • NPI 1669457180
  Medicare reassignment Care Compare group NPD
• Avera St Marys

  • Emergency Medicine Physician
  • Pierre, SD
  • NPI 1073305496
  NPD

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1649047754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E SIOUX AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013323",
            "telephone_number": "605-224-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E SIOUX AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013323",
            "telephone_number": "605-224-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDVEY",
        "first_name": "LOGAN",
        "middle_name": "MCKENZIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "2427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOGAN",
            "last_name": "GESINGER",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Weller, PT
• Rita L Wendt, RNA
• Jonathan Joseph Werner, MD
• Wendy Whitaker, MSW, CSW, CATC
• Jenna Wickersham, D.O.
• Kenna Wieczorek, OTD, OTR/L
• Workit Health Mi PLLC
• Joseph O Wyatt, MD
• Kevin Allen Yackley, CRNA
• Shannon Zeeb, RPH

• Physical Therapist in Pierre, SD
• Providers in Pierre, SD by specialty
• Physical Therapist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.