Individual provider Active NPI

Logan Rollins Duffy

  • Physical Therapist
  • Indian Trail, NC
National Provider Identifier
1700619467
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24726 Issued in NC
Practice address
4514 Old Monroe Rd Ste B
Indian Trail, NC 28079-5308
Phone
(980) 890-8850
NPI assigned
Aug 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X P24726 NC Primary

Addresses

Primary practice location

4514 Old Monroe Rd Ste B
Indian Trail, NC 28079-5308

Mailing address

4212 Matthews LN
Kensington, MD 20895-4036
Phone (703) 919-1913

Other practice location 1

14955 Shady Grove Rd
Rockville, MD 20850-8700
Phone (301) 984-6594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260224002084 NC Practitioner - Physical Therapist in Private Practice 6204317670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

4514 Old Monroe Rd
Suite B
Indian Trail, NC 28079-5308
Phone (980) 890-8850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P24726NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab North Carolina LLC CurrentSince Feb 10, 2026 Accepting new patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Feb 10, 2026 Accepting new patients

Locations

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

4514 Old Monroe Rd
#B
Indian Trail, NC 28079
Phone (980) 890-8850

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1700619467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 MATTHEWS LN",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208954036",
            "telephone_number": "703-919-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4514 OLD MONROE RD STE B",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795308",
            "telephone_number": "980-890-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14955 Shady Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208508700",
            "country_code": "US",
            "telephone_number": "301-984-6594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "LOGAN",
        "middle_name": "ROLLINS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-20",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; 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.