Logan Internal Medicine Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LOGAN INTERNAL MEDICINE GROUP

Doing business as

Logan Internal Medicine Group

Practice address

77 Hospital Drive
Suite 101
Logan, WV 25601-3451

Phone

(304) 831-0450

Fax

(304) 831-0452

NPI assigned

Jun 29, 2006

Organization subpart

No

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

Authorized official

Name

Fernando Luis Gonzalez-Ramos, MD

Title

Ceo

Phone

(304) 831-0450

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Logan Internal Medicine Group Doing business as

Locations

Practitioners 1

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

• Linda Rita Boggs, PA-C

  • Medical Physician Assistant
  • Clinton, NC
  • NPI 1437192127
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1730117896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1617",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256011617",
            "telephone_number": "304-831-0450",
            "fax_number": "304-831-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL DRIVE",
            "address_2": "SUITE 101",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013451",
            "telephone_number": "304-831-0450",
            "fax_number": "304-831-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN INTERNAL MEDICINE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ-RAMOS",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-831-0450",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011047",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "001860338",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "001860338",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF2728",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA FREEDOM",
            "identifier": "438170",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH",
            "identifier": "438170",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "611399500",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan Internal Medicine Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Logan General Hospital LLC (Logan Regional Primary Care - Logan)
• Logan General Hospital LLC (Logan Regional Medical Center - Rehabilitation Unit)
• Logan General Hospital LLC
• Logan General Hospital LLC (Logan Regional Medical Center)
• Logan Hematology-Oncology Inc
• Logan Mingo Area Mental Health
• Logan Mingo Area Mental Health
• Logan Mingo Area Mental Health Inc
• Logan Oncology Care Associates, LLC (Logan Regional Cancer Center)
• Logan Park Care Center, Inc.

• Internal Medicine Physician in Logan, WV
• Providers in Logan, WV by specialty
• Internal Medicine Physician in West Virginia

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

Verify at the official NPI Registry.