Active NPI
Logan Glen Woolf, DPT
- Physical Therapist
- Fort Smith, AR
National Provider Identifier
1902638042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5533
- Practice address
- 6700 Chad Colley Blvd
Fort Smith, AR 72916-6120 - Phone
- (479) 974-5700
- NPI assigned
- Aug 16, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5533 | AR | Primary |
Addresses
Primary practice location
6700 Chad Colley Blvd
Fort Smith, AR 72916-6120
Mailing address
13255 S Highway 265
Prairie Grove, AR 72753-8340
Phone (573) 247-2893
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5533 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1902638042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13255 S HIGHWAY 265",
"city": "PRAIRIE GROVE",
"state": "AR",
"postal_code": "727538340",
"telephone_number": "573-247-2893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 CHAD COLLEY BLVD",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729166120",
"telephone_number": "479-974-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLF",
"first_name": "LOGAN",
"middle_name": "GLEN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-16",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "5533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.