Logan M Rettew

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

Practice address

1211 Heidi LN S
Lakeland, FL 33813-2321

Phone

(727) 251-2044

NPI assigned

Nov 13, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Consultants of Central Florida,LLCGroup PAC ID 5092813410, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

Practice roles

Locations

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.

• Anesthesia Consultants of Central Florida,LLC

  • Pain Medicine (Anesthesiology) Physician
  • Winter Haven, FL
  • NPI 1578681664
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1972977908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 HEIDI LN S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132321",
            "telephone_number": "727-251-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HEIDI LN S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132321",
            "telephone_number": "727-251-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTEW",
        "first_name": "LOGAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AA320",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian E Renz, MD
• John Repetosky
• Lynn M Repetosky, LMHC
• Alysia S Reppeto-Evans, COTA/L
• Respiratory Care
• Revive & New Life Homecare Services LLC
• Rexus Healthcare Associates LLC
• Melisa Laura Rey Diaz
• Jacqueline J. Reycraft, LMHC
• Aneliz Reyes Perez

• Anesthesiologist Assistant in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Anesthesiologist Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.