Millie Josie Logan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN6859 Issued in TN

Practice address

3175 Lenox Park Blvd
Memphis, TN 38115-4260

Phone

(901) 273-2360

NPI assigned

Jul 27, 2007

Last updated

Jun 10, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Millie Josie Dailey Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• SSM Health Care St Louis

  dba SSM Health St Clare Fenton

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174
  Medicare reassignment NPD
• SSM Health Care St. Louis

  dba SSM Health DePaul Hospital

  • Cardiovascular Disease Physician
  • Bridgeton, MO
  • NPI 1376598599
  NPD
• Memphis Psychiatric and Addiction Clinic, PC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Memphis, TN
  • NPI 1235187949
  NPD (past)
• Pathways of Tennessee, Inc.

  • Clinic/Center
  • Jackson, TN
  • NPI 1497721609
  NPD (past)
• Psycare LLC

  • Psychologist
  • Memphis, TN
  • NPI 1851870778
  NPD (past)

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1750571642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7274 TIMBERLEY CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198908",
            "telephone_number": "901-624-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 LENOX PARK BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381154260",
            "telephone_number": "901-273-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "MILLIE",
        "middle_name": "JOSIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN6859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33468511",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILLIE",
            "last_name": "DAILEY",
            "middle_name": "JOSIE",
            "prefix": "MS.",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Angela Powell Logan, RRT
• Chase Logan
• Connor Logan, MD
• Emily Kyle Logan, MSN, APRN
• Kansas Shanee Logan
• Savannah Logan, RBT
• Ursula Logan, CERT HAIRLOSS SPC
• Blythe Logue
• Hong Pheng Amos Loh, MD
• Katherine Lohman, NP

• Family Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.