Logan Woodall

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305213619 Issued in VA

Practice address

118 Oakwood Dr Ste B
Madison Heights, VA 24572-3001

Phone

(434) 845-5641

Fax

(434) 509-1695

NPI assigned

May 6, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1942821491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20347 TIMBERLAKE RD STE B",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245027352",
            "telephone_number": "434-845-5641",
            "fax_number": "434-509-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 OAKWOOD DR STE B",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245723001",
            "telephone_number": "434-845-5641",
            "fax_number": "434-509-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarence Edward Wesley, PERSONAL PROVIDER
• Tanya Chera West, PMHNP
• Jeff Williams
• Cindy Wingfield
• Sonya Reagin Wodicka, PHARMACIST
• Kelsey Taylor York, LPTA
• Sandra Esther Zuker, FNP-C
• Holly N Zuniga, LMFT

• Physical Therapist in Madison Heights, VA
• Providers in Madison Heights, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.