Individual provider Active NPI

Linda Jean Logan, MASTER OF ARTS

  • Audiologist
  • Richfield, MN
National Provider Identifier
1689710956
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5713 Issued in MN
Practice address
6625 Lyndale Ave S Ste 105
Richfield, MN 55423-2673
Phone
(612) 243-8999
Fax
(612) 869-3473
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY1299 FL
Audiologist 231H00000X 5713 MN Primary

Addresses

Primary practice location

6625 Lyndale Ave S Ste 105
Richfield, MN 55423-2673

Mailing address

6625 Lyndale Ave S Ste 300
Richfield, MN 55423-2491
Phone (612) 243-8999

Other practice location 1

8150 University Ave NE
Sam's Club Hearing Aid Center
Fridley, MN 55432-1864
Phone (612) 252-0167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY1299FLMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1689710956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-243-8999",
            "fax_number": "612-869-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 105",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232673",
            "telephone_number": "612-243-8999",
            "fax_number": "612-869-3473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8150 University Ave NE",
            "address_2": "Sam's Club Hearing Aid Center",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554321864",
            "country_code": "US",
            "telephone_number": "612-252-0167",
            "fax_number": "763-792-6656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "LINDA",
        "middle_name": "JEAN",
        "credential": "MASTER OF ARTS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1299",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "5713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.