Active NPI
Stefanie Ann Logue, OTD OTRL
- Occupational Therapist
- Cary, NC
National Provider Identifier
1972704351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6367
- Practice address
- 981 High House Rd
Ste 100
Cary, NC 27513-3510 - Phone
- (919) 388-0111
- Fax
- (919) 388-8668
- NPI assigned
- May 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 6367 | NC | Primary |
Addresses
Primary practice location
981 High House Rd
Ste 100
Cary, NC 27513-3510
Mailing address
981 High House Rd
Ste 100
Cary, NC 27513-3510
Phone (919) 388-0111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145CU | Other | NC | BCBS OF NC |
| 7302007 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6367 | NC | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314576000000",
"number": "1972704351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "981 HIGH HOUSE RD",
"address_2": "STE 100",
"city": "CARY",
"state": "NC",
"postal_code": "275133510",
"telephone_number": "919-388-0111",
"fax_number": "919-388-8668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "981 HIGH HOUSE RD",
"address_2": "STE 100",
"city": "CARY",
"state": "NC",
"postal_code": "275133510",
"telephone_number": "919-388-0111",
"fax_number": "919-388-8668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGUE",
"first_name": "STEFANIE",
"middle_name": "ANN",
"credential": "OTD OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2011-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "6367",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "145CU",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7302007",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.