Kristen Elizabeth Logan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502005684 Issued in MI

Practice address

879 E Michigan Ave
Marshall, MI 49068-2045

Phone

(269) 781-4251

NPI assigned

Oct 14, 2018

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1539475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539475200000",
    "number": "1952877201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 KINGMAN AVE E",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145138",
            "telephone_number": "517-418-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "879 E MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490682045",
            "telephone_number": "269-781-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-14",
        "last_updated": "2018-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Marshall, MI
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2018; 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.