Active NPI
Mimia Cynthia Logsdon, ARNP
- Women's Health Nurse Practitioner
- Louisville, KY
National Provider Identifier
1912065699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 2758P
- Practice address
- 4130 Dutchmans LN
Suite 400
Louisville, KY 40207-4713 - Phone
- (502) 897-0697
- Fax
- (502) 897-0658
- NPI assigned
- Dec 5, 2006
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 2758P | KY | Primary |
Addresses
Primary practice location
4130 Dutchmans LN
Suite 400
Louisville, KY 40207-4713
Mailing address
4130 Dutchmans LN
Suite 400
Louisville, KY 40207-4713
Phone (502) 897-0697
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2758P | KY | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1912065699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4130 DUTCHMANS LN",
"address_2": "SUITE 400",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074713",
"telephone_number": "502-897-0697",
"fax_number": "502-897-0658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4130 DUTCHMANS LN",
"address_2": "SUITE 400",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074713",
"telephone_number": "502-897-0697",
"fax_number": "502-897-0658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGSDON",
"first_name": "MIMIA",
"middle_name": "CYNTHIA",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "KY",
"license": "2758P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.