Nicole Logue, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5880 Issued in CT

Practice address

42 Artillery Rd
Woodbury, CT 06798-2308

Phone

(203) 228-2116

NPI assigned

Aug 26, 2014

Last updated

Jan 24, 2020By 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 2

Addresses

Other names 1

• Nicole Butler Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Impact Health PCGroup PAC ID 0941562664, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: ms_nbutler2@landmarkhealth-direct.org

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.

• Impact Health P.C.

  • Nurse Practitioner
  • Orange, CT
  • NPI 1730694316
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1881094936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 ARTILLERY RD",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067982308",
            "telephone_number": "203-228-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 ARTILLERY RD",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067982308",
            "telephone_number": "203-228-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGUE",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "5880",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "5880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BUTLER",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Layman, N.D.
• Julie Adrienne Levesque, LPC
• Steven L Levy, D.C.
• Litchfield Health, Inc.
• Litchfield Hills Integrative Therapy
• Alison Marie Luciano, LCSW
• Stephanie Lynam, PSY.D.
• Saloua Mabkhouti, APRN
• Christina D Macinnis, MS, LADC, NCC
• Courtney Malcolm, MSW, LCSW

• Adult Health Nurse Practitioner in Woodbury, CT
• Providers in Woodbury, CT by specialty
• Adult Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.