Charlotte A Logan, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

4301070300 Issued in MI

Practice address

4201 Saint Antoine St
Detroit, MI 48201-2153

Phone

(313) 745-3000

NPI assigned

Mar 28, 2006

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 identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clogan138694@direct-guthrie.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• LR Health Services PLLC

  • Multi-Specialty Clinic/Center
  • Southfield, MI
  • NPI 1376488270
  NPD Authorized official
• Des Moines River Physicians, LLC

  • Emergency Medicine Physician
  • Des Moines, IA
  • NPI 1720472442
  NPD
• The Milton S Hershey Medical Center Physicians Group

  • Orthopaedic Surgery Physician
  • Hershey, PA
  • NPI 1710951744
  NPD
• Epmg of Michigan, P.C.

  • Emergency Medicine Physician
  • Livonia, MI
  • NPI 1386688992
  NPD (past)
• Flowing Waters Emergency Physicians

  • Emergency Medicine Physician
  • Watervliet, MI
  • NPI 1801950936
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1891756243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18461 WOODINGHAM DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "CHARLOTTE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD438501",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301070300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104205740",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104649020",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104205730",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891756243",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104317183",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MI",
            "identifier": "CL070300",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lomyda Mechon Lofton-Irving, MSW, LLMSW
• Joanna Lofton
• Andrew Loftus, M.D.
• Logan International LLC
• Andrea Michelle Logan, LLPC, QMHP
• Jennifer Leigh Logan, NP
• Kim Janisse Logan, PH.D.,LPC,BCPC
• Lanier Charles Logan
• Mary Elizabeth Logan, CPHT
• Stephanie Logan

• Emergency Medical Services (Emergency Medicine) Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.