Active NPI
Alesha Nicole Logan, FNP-BC
- Family Nurse Practitioner
- Gastonia, NC
National Provider Identifier
1922481894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 233239
- Practice address
- 1895 Hoffman Rd Ste a
Gastonia, NC 28054 - Phone
- (704) 865-1749
- Fax
- (704) 865-7328
- NPI assigned
- Jul 9, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71005545A | IN | |
| Family Nurse Practitioner | 363LF0000X | 233239 | NC | Primary |
Addresses
Primary practice location
1895 Hoffman Rd Ste a
Gastonia, NC 28054
Mailing address
1895 Hoffman Rd Ste a
Gastonia, NC 28054-6557
Phone (704) 865-1749
Other practice location 1
6814 W Raleigh Dr
McCordsville, IN 46055
Phone (317) 966-9856
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201300410 | Medicaid | IN | |
| P01512421 | Other | IN | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 30, 2021 through Jun 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- alesha.logan@326074407845892.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559174400000",
"number": "1922481894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1895 HOFFMAN RD STE A",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280546557",
"telephone_number": "704-865-1749",
"fax_number": "704-865-7328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1895 HOFFMAN RD STE A",
"city": "GASTONIA",
"state": "NC",
"postal_code": "28054",
"telephone_number": "704-865-1749",
"fax_number": "704-865-7328"
}
],
"practiceLocations": [
{
"address_1": "6814 W Raleigh Dr",
"address_purpose": "LOCATION",
"city": "McCordsville",
"state": "IN",
"postal_code": "46055",
"country_code": "US",
"telephone_number": "317-966-9856",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOGAN",
"first_name": "ALESHA",
"middle_name": "NICOLE",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-09",
"last_updated": "2019-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71005545A",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "233239",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201300410",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01512421",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.