NPIMap

Organization Active NPI

Patrick K Hayden Logan Family Practice

  • Family Medicine Physician
  • Russellville, KY
National Provider Identifier
1760594840
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PATRICK K HAYDEN LOGAN FAMILY PRACTICE
Practice address
1719 Nashville St
Suite C
Russellville, KY 42276-8855
Phone
(270) 726-7664
Fax
(270) 726-9997
NPI assigned
Aug 31, 2006
Last updated
Jun 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Dr. Patrick Kevin Hayden, M.D.NPI 1295847184
Title
Owner
Phone
(270) 726-7664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1719 Nashville St
Suite C
Russellville, KY 42276-8855

Mailing address

1719 Nashville St
Suite C
Russellville, KY 42276-8855
Phone (270) 726-7664

Other identifiers 1

IdentifierTypeStateIssuer
65929481MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1760594840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 NASHVILLE ST",
            "address_2": "SUITE C",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422768855",
            "telephone_number": "270-726-7664",
            "fax_number": "270-726-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 NASHVILLE ST",
            "address_2": "SUITE C",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422768855",
            "telephone_number": "270-726-7664",
            "fax_number": "270-726-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK K HAYDEN LOGAN FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "HAYDEN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-726-7664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65929481",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.