Individual provider Active NPI

Logan Richards, MD

  • Diagnostic Radiology Physician
  • Bozeman, MT
National Provider Identifier
1871171165
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MED-PHYS-LIC-173116 Issued in MT
Practice address
1648 Ellis St Ste 201
Bozeman, MT 59715-8811
Phone
(406) 587-8631
Fax
(406) 587-1343
NPI assigned
Mar 30, 2021
Last updated
May 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X MED-PHYS-LIC-173116 MT Primary

Addresses

Primary practice location

1648 Ellis St Ste 201
Bozeman, MT 59715-8811

Mailing address

1648 Ellis St Ste 201
Bozeman, MT 59715-8811
Phone (406) 587-8631

Other practice location 1

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-2361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260610003214 MT Practitioner - Diagnostic Radiology 4183023963

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Dakota School of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1648 Ellis St
Suite 201
Bozeman, MT 59715-8811

324 Gannett Dr
Suite 200
South Portland, ME 04106-3263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-173116MTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Intercity Imaging LLC CurrentSince Jul 26, 2026 Accepting new patients

Locations

1648 Ellis St
Ste 201
Bozeman, MT 59715
Phone (406) 556-4649

905 Highland Blvd
Ste 4100
Bozeman, MT 59715
Phone (406) 556-5200

915 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-1720

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.

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1871171165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 ELLIS ST STE 201",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158811",
            "telephone_number": "406-587-8631",
            "fax_number": "406-587-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 ELLIS ST STE 201",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158811",
            "telephone_number": "406-587-8631",
            "fax_number": "406-587-1343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Gaston Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752462017",
            "country_code": "US",
            "telephone_number": "214-820-2361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "LOGAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MT",
            "license": "MED-PHYS-LIC-173116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.