Stacey M Lettis Logan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

7772 Issued in AK

Practice address

2925 Debarr Rd
Suite 230
Anchorage, AK 99508-2959

Phone

(907) 777-1800

NPI assigned

Jul 2, 2008

Last updated

Jun 29, 2016By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9493/brand/2/csg/1/fhir/r4
• Direct secure messaging: stacey.logan.1@9493.direct.athenahealth.com

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.

• Alaska Center for Pediatrics, LLC

  • Multi-Specialty Clinic/Center
  • Anchorage, AK
  • NPI 1659581635
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1972765774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 DEBARR RD",
            "address_2": "SUITE 230",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082959",
            "telephone_number": "907-777-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 DEBARR RD",
            "address_2": "SUITE 230",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082959",
            "telephone_number": "907-777-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTIS LOGAN",
        "first_name": "STACEY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "7772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1585092",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tautalasoo Letalu
• Timothy Michael Lethin
• Jennifer Rene Letourneau
• Mary Letourneau
• Kellye Natasha Lett
• Crystal Mae Leturno, LMT
• Aroma Leupolu
• Nicole Levaillant, PSY.D
• Aryeh Leib Levenson, M.D.
• Selma Maria Leveridge

• Pediatrics Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Pediatrics Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.