Michael Stephen Logue, FAM NRS PRAC FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

135879 Issued in MO

Practice address

10012 Kennerly Road
Suite # 301
St Louis, MO 63128

Phone

(314) 894-0787

Fax

(314) 729-1489

NPI assigned

May 30, 2006

Last updated

Nov 7, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heart Care Specialists LLCGroup PAC ID 2062774755, 16 clinicians

Heart Health Specialists, LLCGroup PAC ID 3779727565, 10 clinicians

Cardiac Specialists of St Lukes LLCGroup PAC ID 6709810880, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Cardiac Specialists of St Luke's, LLC

  • Cardiovascular Disease Physician
  • Chesterfield, MO
  • NPI 1285691063
  Medicare reassignment Care Compare group NPD
• Heart Care Specialists, LLC

  • Medical Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1275031866
  Medicare reassignment Care Compare group NPD
• Heart Health Specialists, LLC

  • Cardiovascular Disease Physician
  • Chesterfield, MO
  • NPI 1053756296
  Medicare reassignment Care Compare group NPD
• Chesterfield Cardiology Care, LLC

  • Cardiovascular Disease Physician
  • Chesterfield, MO
  • NPI 1134672587
  Medicare reassignment NPD
• John P Marino MD LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1124359237
  NPD (past)
• St. Louis Electrophysiology Specialists, LLC

  • Clinical Cardiac Electrophysiology Physician
  • Chesterfield, MO
  • NPI 1629439187
  NPD (past)
• St. Lukes Medical Group

  • Family Medicine Physician
  • Chesterfield, MO
  • NPI 1215308945
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  dba St. Luke's Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1750338919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11140 S TOWNE SQUARE",
            "address_2": "SUITE # 105",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63123",
            "telephone_number": "314-894-0787",
            "fax_number": "314-729-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY ROAD",
            "address_2": "SUITE # 301",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-894-0787",
            "fax_number": "314-729-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGUE",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "FAM NRS PRAC FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "135879",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209004468",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCLUSIVE CHOICE",
            "identifier": "072289",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356650631001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7196539",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "189482",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "46286",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00117390",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429176605",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "652432",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Logan, PTA
• William R Logan, MD
• Macdonald B Logie, MD
• Steven Lograsso, CRNA
• Kathleen Anne Logsdon
• Francis Erik Fu-Chuan Loh, MD
• Ashley Rae Lohman, AU.D.
• Kathryn Anne Lohmann, PA-C
• David Lohmeyer, RPH
• Austin Lohse

• Family Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.