NPIMap

Organization Active NPI

Logan Pediatrics, Inc

  • Specialist
  • Logan, WV
National Provider Identifier
1720299803
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21990 Issued in WV
Legal business name
LOGAN PEDIATRICS, INC
Practice address
60 Hospital Dr
Logan, WV 25601-3452
Phone
(304) 831-0073
Fax
(304) 831-0076
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Dr. Okpani M Nnachi, M.D.
Title
Medical Director
Phone
(304) 831-0073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 21990 WV Primary

Addresses

Primary practice location

60 Hospital Dr
Logan, WV 25601-3452

Mailing address

PO Box 117
Logan, WV 25601-0117
Phone (304) 831-0073

Other identifiers 1

IdentifierTypeStateIssuer
3810012095MedicaidWV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1720299803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256010117",
            "telephone_number": "304-831-0073",
            "fax_number": "304-831-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013452",
            "telephone_number": "304-831-0073",
            "fax_number": "304-831-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN PEDIATRICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "NNACHI",
        "authorized_official_first_name": "OKPANI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "304-831-0073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "21990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012095",
            "state": "WV"
        }
    ],
    "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 Jul 2, 2008; 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.