Individual provider Active NPI

Logan Weeks

  • Speech-Language Pathologist
  • Evans, GA
National Provider Identifier
1972051951
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP010017 Issued in GA
Practice address
536 Grand Slam Dr Ste 2
Evans, GA 30809-8045
Phone
(706) 854-8434
NPI assigned
Sep 19, 2016
Last updated
Feb 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6125 SC
Speech-Language Pathologist 235Z00000X SLP010017 GA Primary

Addresses

Primary practice location

536 Grand Slam Dr Ste 2
Evans, GA 30809-8045

Mailing address

536 Grand Slam Dr Ste 2
Evans, GA 30809-8045
Phone (706) 854-8434

Other practice location 1

1446 Harper St
Augusta, GA 30912-8045
Phone (706) 721-5437

Other practice location 2

6140 Woodside Executive Ct
Aiken, SC 29803-3820
Phone (803) 642-0700

Other names 1

  • Logan Tingler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210712003422 GA Practitioner - Qualified Speech Language Pathologist 3779985841 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Center, Inc CurrentSince Jul 1, 2021 Accepting new patients
Au Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Au Medical Associates Inc Current Accepting new patients
Pediatric Pals LLC Speech-Language Pathologist Current Accepting new patients
Pediatric Therapy of Aiken, LLC Speech-Language Pathologist Past Accepting new patients
Pediatric Therapy of Aiken, LLC Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1446 Harper St
Augusta, GA 30912
Phone (706) 721-5223

1367 W Martintown Rd
Ste 1
North Augusta, SC 29860

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1972051951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR STE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098045",
            "telephone_number": "706-854-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR STE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098045",
            "telephone_number": "706-854-8434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1446 Harper St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309128045",
            "country_code": "US",
            "telephone_number": "706-721-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6140 Woodside Executive Ct",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298033820",
            "country_code": "US",
            "telephone_number": "803-642-0700",
            "fax_number": "803-642-0588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEEKS",
        "first_name": "LOGAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "6125",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOGAN",
            "last_name": "TINGLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.