Active NPI
Samuel Logan
- Case Manager/Care Coordinator
- Ukiah, CA
National Provider Identifier
1699059659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 350 E Gobbi St
Ukiah, CA 95482-5511 - Phone
- (707) 472-2922
- NPI assigned
- Oct 7, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
350 E Gobbi St
Ukiah, CA 95482-5511
Mailing address
6431 Black Bart TRL
Redwood Valley, CA 95470-6248
Phone (707) 467-9192
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1699059659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6431 BLACK BART TRL",
"city": "REDWOOD VALLEY",
"state": "CA",
"postal_code": "954706248",
"telephone_number": "707-467-9192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 E GOBBI ST",
"city": "UKIAH",
"state": "CA",
"postal_code": "954825511",
"telephone_number": "707-472-2922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-07",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.