Logan Samuel Krass

Primary specialty

PharmacistTaxonomy code 183500000X

License

033.0134823 Issued in VT

Practice address

412 Broad St
Lyndonville, VT 05851-8623

Phone

(802) 626-4366

Fax

(802) 626-4370

NPI assigned

Oct 31, 2022

Last updated

Oct 31, 2022By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1851008858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 BROAD ST",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058518623",
            "telephone_number": "802-626-4366",
            "fax_number": "802-626-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 BROAD ST",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058518623",
            "telephone_number": "802-626-4366",
            "fax_number": "802-626-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASS",
        "first_name": "LOGAN",
        "middle_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033.0134823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "na",
            "affiliation": "N",
            "address_1": "412 Broad St",
            "city": "Lyndonville",
            "state": "VT",
            "country_code": "US",
            "postal_code": "058518623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Lyndonville, VT
• Providers in Lyndonville, VT by specialty
• Pharmacist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.