Individual provider Active NPI

Logan Gary Foltz, MD

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1730490640
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
8963607-1205 Issued in UT
Practice address
324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885
Phone
(801) 408-8500
Fax
(801) 408-8510
NPI assigned
Jun 24, 2010
Last updated
Aug 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LL32913 SC
Psychiatry Physician 2084P0800X 8963607-1205 UT Primary

Addresses

Primary practice location

324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

169 Ashley Ave
Room 202 Main Hospital, MSC333
Charleston, SC 29425-8905
Phone (843) 792-2575

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address logan.foltz@direct.imail.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140627001182 UT Practitioner - Psychiatry 5092967430 Reassigns benefits to 1 organization
I20200317000317 MD Practitioner - Psychiatry 5092967430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
067217GAMDLicensed Practical Nurse
LL32913SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Western Maryland Corporation CurrentSince Feb 3, 2020 Accepting new patients
Upmc Western Maryland Corporation Current Accepting new patients
Upmc Western Maryland Corporation Psychiatry CurrentSince Feb 3, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince May 6, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Upmc Western Maryland Health Services, LLC Past Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

12502 Willowbrook Rd
Ste 380
Cumberland, MD 21502
Phone (240) 964-8585

1313 National Hwy
Lavale, MD 21502
Phone (240) 362-0288

324 Tenth Ave
Ste 178
Slc, UT 84103
Phone (801) 321-2500

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1730490640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 10TH AVE STE 178",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032885",
            "telephone_number": "801-408-8500",
            "fax_number": "801-408-8510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_2": "Room 202 Main Hospital, MSC333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-792-2575",
            "fax_number": "843-792-9295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOLTZ",
        "first_name": "LOGAN",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL32913",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "8963607-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "logan.foltz@direct.imail.org",
            "affiliation": "N",
            "address_1": "324 E 10th Ave Ste 178",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841032885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.