Kathleen M Logan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

11343A Issued in WY

Practice address

555 E Broadway Ave Ste 204
Jackson, WY 83001-8640

Phone

(307) 739-4818

Fax

(888) 329-5701

NPI assigned

Dec 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Teton County Hospital District

  dba St John's Medical Center/ or St John's Health

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  NPD (past)
• Teton County Hospital District

  dba St. John's Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Jackson, WY
  • NPI 1801929997
  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1699752089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830010428",
            "telephone_number": "307-739-4818",
            "fax_number": "888-329-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E BROADWAY AVE STE 204",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018640",
            "telephone_number": "307-739-4818",
            "fax_number": "888-329-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "25358",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WY",
            "license": "11343A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150491600",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klogan@sjmc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address for St John's Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "555 E Broadway Ave Ste 204",
            "city": "Jackson",
            "state": "WY",
            "country_code": "US",
            "postal_code": "830018640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Russell Little, MD
• LJC,Inc Dba Stone Drug
• Maura J. Lofaro, MD, FACOG
• Maria E Lofgren, P.T.
• Elizabeth E Logan, O.T.R. C.H.T.
• Lindsay M Long, LCSW
• Rachel Long, PCSW
• Jamie Loomis
• Antuanett Lopez Sani, MA, LPC
• Stephen Stuart Lottridge, PSY.D.

• Psychiatry Physician in Jackson, WY
• Providers in Jackson, WY by specialty
• Psychiatry Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.