Logan Reddy, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61231005 Issued in WA

Practice address

5730 Ruddell Rd SE Ste a
Lacey, WA 98503-6400

Phone

(360) 338-3901

NPI assigned

Mar 13, 2024

Last updated

Nov 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Center for Sports Medicine and Physical Therapy IncGroup PAC ID 1759278542, 88 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northwest Center for Sports Medicine & Physical Therapy Inc

  dba Northwest Sports Physical Therapy

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of Oregon LLC

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1801257191
  Medicare reassignment NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Ashland, OR
  • NPI 1366935702
  NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Roseburg, OR
  • NPI 1427524388
  NPD
• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  dba Northwest Sports Physical Therapy, Inc.

  • Physical Therapist
  • Tacoma, WA
  • NPI 1225582844
  NPD (past)

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1912766916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 ELGAR ST",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221513132",
            "telephone_number": "540-470-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 RUDDELL RD SE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985036400",
            "telephone_number": "360-338-3901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "497 SW Ramsey Ave",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975275681",
            "country_code": "US",
            "telephone_number": "541-476-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "2305211938",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61231005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Real Heal, PLLC
• Connie Pauline Reandeau, ARNP
• Alicia Reaume
• Penporn Vongsvivut Reck, MD
• Stephen D Reck, MD
• Lauren Reed
• Reflections Therapy, PLLC
• Rowena R Regala, PHYSICAL THERAPIST
• Heather Marie Rehaume, MFT, CC
• Cary C Reid

• Physical Therapist in Lacey, WA
• Providers in Lacey, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.