Active NPI
Kennedy Alxya Logsdon, ATC, LAT
- Athletic Trainer
- Frostburg, MD
National Provider Identifier
1740709732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A00984
- Practice address
- 100 Dr. Gasmick Lane
Frostburg, MD 21532 - Phone
- (301) 268-2700
- NPI assigned
- Sep 12, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | A00984 | MD | Primary |
Addresses
Primary practice location
100 Dr. Gasmick Lane
Frostburg, MD 21532
Mailing address
100 Dr. Gasmick Lane
Frostburg, MD 21532
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A00984 | Other | MD | MARYLAND BOARD OF PHYSICIANS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A00984 | MD | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505174400000",
"number": "1740709732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 DR. GASMICK LANE",
"city": "FROSTBURG",
"state": "MD",
"postal_code": "21532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 DR. GASMICK LANE",
"city": "FROSTBURG",
"state": "MD",
"postal_code": "21532",
"telephone_number": "301-268-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGSDON",
"first_name": "KENNEDY",
"middle_name": "ALXYA",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-12",
"last_updated": "2017-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MD",
"license": "A00984",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND BOARD OF PHYSICIANS",
"identifier": "A00984",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frostburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.