NPIMap

Organization Active NPI

Logan General Hospital LLC

  • Podiatrist
  • Logan, WV
National Provider Identifier
1720032105
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
LOGAN GENERAL HOSPITAL LLC
Practice address
20 Hospital Dr
Logan, WV 25601-3452
Phone
(304) 831-1101
Fax
(304) 831-1958
NPI assigned
May 20, 2006
Last updated
Sep 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7688

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Body Imaging Physician 2085B0100X
Diagnostic Radiology Physician 2085R0202X
Surgery Physician 208600000X
General Practice Physician 208D00000X
Podiatrist 213E00000X Primary
Certified Registered Nurse Anesthetist 367500000X

Addresses

Primary practice location

20 Hospital Dr
Logan, WV 25601-3452

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, CT, NJ, MI, ME, PA6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20031217001124 WV Part B Supplier - Clinic/Group Practice 9537078977 Receives reassigned benefits from 50 practitioners
3 other NPIs on this enrollment
Practice locations: Logan, WV; Chapmanville, WV; Champanville, WV
O20240522001296 CT Part B Supplier - Clinic/Group Practice 9537078977 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbridge, CT
O20240522004175 NJ Part B Supplier - Clinic/Group Practice 9537078977 Receives reassigned benefits from 1 practitioner
Practice locations: Bridgewater, NJ
O20240613002418 MI Part B Supplier - Clinic/Group Practice 9537078977 Receives reassigned benefits from 1 practitioner
Practice locations: Orchard Lake, MI
O20240729002604 ME Part B Supplier - Clinic/Group Practice 9537078977 Receives reassigned benefits from 1 practitioner
Practice locations: Scarborough, ME
O20240913003128 PA Part B Supplier - Clinic/Group Practice 9537078977 Receives reassigned benefits from 1 practitioner
Practice locations: Pittsburgh, PA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

135 Bills Branch Rd
Logan, WV 25601
Phone (304) 752-8723

1690 Holden Rd
Fl 1
Logan, WV 25601

38 Hospital Dr
Ste 1A
Logan, WV 25601
Phone (304) 831-1892

38 Hospital Dr
Ste Ga
Logan, WV 25601
Phone (304) 831-1480

60 Hospital Dr
Logan, WV 25601
Phone (304) 831-0073

77 Hospital Dr
#1
Logan, WV 25601

77 Hospital Dr
Fl 1
Logan, WV 25601

77 Hospital Dr
Fl 3
Logan, WV 25601

77 Hospital Dr
Fl 4
Logan, WV 25601
Phone (304) 831-1663

79 Hospital Dr
Logan, WV 25601
Phone (304) 831-1594

Practitioners & affiliated clinicians

Practitioners 69

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1720032105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013452",
            "telephone_number": "304-831-1101",
            "fax_number": "304-831-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN GENERAL HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7688"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.