Kenneth D Logan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G50800 Issued in CA

Practice address

15151 Little Ron Rd
Chico, CA 95973-9455

Phone

(530) 571-2034

Fax

(530) 896-4893

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klogan15329@enloedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Enloe Medical Center

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Chico, CA
  • NPI 1164885604
  Medicare reassignment NPD
• Enloe Medical Center

  • Community/Retail Pharmacy
  • Chico, CA
  • NPI 1912949538
  NPD

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1962407825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 W EAST AVE",
            "address_2": "PMB 252",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959267235",
            "telephone_number": "530-571-2034",
            "fax_number": "530-896-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15151 LITTLE RON RD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959739455",
            "telephone_number": "530-571-2034",
            "fax_number": "530-896-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "KENNETH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G50800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G508000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Michael Lobosky, M.D.
• Local Medical Motion Inc
• Sable Locci
• Shawn Thomas Lockard
• Joe A Lodge, BSW
• Harry Lomas IV, M.D.
• Baneli Lomeli
• Bradley Dean Long, RASI
• Donald Wayne Long II
• Heather Leigh Long

• Family Medicine Physician in Chico, CA
• Providers in Chico, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.