Active NPI
Elizabeth Logan
- Family Nurse Practitioner
- Melbourne, FL
National Provider Identifier
1851721302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP9232775
- Practice address
- 1130 Hickory St Ste B
Melbourne, FL 32901-1973 - Phone
- (321) 361-5599
- Fax
- (321) 952-6179
- NPI assigned
- Nov 20, 2013
- Last updated
- Sep 26, 2018
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP9232775 | FL | Primary |
Addresses
Primary practice location
1130 Hickory St Ste B
Melbourne, FL 32901-1973
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 361-5599
Other practice location 1
1314 Oak St
Melbourne, FL 32901
Phone (321) 727-7992
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010941200 | Medicaid | FL | |
| HU060Y | Other | FL | MEDICARE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Florida Pathology Associates PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Orlando, FL
- NPI 1255313664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537920000000",
"number": "1851721302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306",
"telephone_number": "321-361-5599",
"fax_number": "321-951-7408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 HICKORY ST STE B",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329011973",
"telephone_number": "321-361-5599",
"fax_number": "321-952-6179"
}
],
"practiceLocations": [
{
"address_1": "1314 Oak St",
"address_purpose": "LOCATION",
"city": "Melbourne",
"state": "FL",
"postal_code": "32901",
"country_code": "US",
"telephone_number": "321-727-7992",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOGAN",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-20",
"last_updated": "2018-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP9232775",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010941200",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "HU060Y",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.