Logan Pediatrics, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

LOGAN PEDIATRICS, INC.

Practice address

354 Airport Rd
Suite 100
Chapmanville, WV 25508

Phone

(304) 855-4544

Fax

(304) 855-5021

NPI assigned

Apr 17, 2023

Last updated

Apr 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Okpani Martin Nnachi, M.D.NPI 1043294739

Title

Medical Director

Phone

(304) 831-0073

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952097321. Details of each certification follow.

• CCN 518904 Rural health clinic · Active · Details

Rural health clinic certification: CCN 518904

Legal name

LOGAN PEDIATRICS, INC

Doing business as

LOGAN PEDIATRICS

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

May 8, 2024

Last certification

May 8, 2024

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Mar 3, 2008 in WV

Enrollment address

354 Airport Rd
Ste 100
Chapmanville, WV 25508-9202

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Logan Pediatrics, Inc

  • Rural Health Clinic/Center
  • Logan, WV
  • NPI 1396409173

  5597835371

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Logan Pediatrics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Logan Pediatrics, Inc

  • Rural Health Clinic/Center
  • Logan, WV
  • NPI 1396409173
  NPD tax ID

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Okpani Martin Nnachi, MD

  • Pediatrics Physician
  • Logan, WV
  • NPI 1043294739
  Authorized official Same address or phone

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1952097321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PROSPERITY LANE",
            "address_2": "SUITE 100",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "25601",
            "telephone_number": "304-831-0073",
            "fax_number": "304-831-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 AIRPORT RD",
            "address_2": "SUITE 100",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "25508",
            "telephone_number": "304-855-4544",
            "fax_number": "304-855-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN PEDIATRICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "NNACHI",
        "authorized_official_first_name": "OKPANI",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "304-831-0073",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Life Solutions Counseling Services, LLC
• Lincoln County Primary Care Center Inc (Southern West Virginia Health System-Chapmanville)
• Lincoln County Primary Care Center, Inc. (CRHS Tiger Center For Health)
• Meghan Loftus
• Logan General Hospital LLC (Logan Regional Primary Care - Chapmanville)
• Alican Hope Lucas, FNP-BC
• Gina Lucas
• Tina Mahon
• Francie Marcum
• Rylee Marcum

• Rural Health Clinic/Center in Chapmanville, WV
• Providers in Chapmanville, WV by specialty
• Rural Health Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.