Individual provider Active NPI

Jennie Lynfred Logue

  • Independent Medical Examiner Chiropractor
  • Los Angeles, CA
National Provider Identifier
1982114476
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X
License
20293 Issued in CA
Practice address
3868 S Centinela Ave Apt 12
Los Angeles, CA 90066-4459
Phone
(818) 619-4041
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Chiropractor 111NI0013X 20293 CA Primary

Addresses

Primary practice location

3868 S Centinela Ave Apt 12
Los Angeles, CA 90066-4459

Mailing address

3868 S Centinela Ave Apt 12
Los Angeles, CA 90066-4459
Phone (818) 619-4041

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220406001372 CA Practitioner - Chiropractic 3072909795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erik Jameson Chiropractic IncGroup PAC ID 5496152290, 2 clinicians

Practice addresses (Care Compare)

1175 N Main St
Lakeport, CA 95453-3858
Phone (707) 349-3124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Erik Jameson Chiropractic Inc. CurrentSince Mar 21, 2022 Accepting new patients

Locations

1175 N Main St
Lakeport, CA 95453
Phone (707) 272-3032

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1982114476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3868 S CENTINELA AVE APT 12",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664459",
            "telephone_number": "818-619-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3868 S CENTINELA AVE APT 12",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664459",
            "telephone_number": "818-619-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGUE",
        "first_name": "JENNIE",
        "middle_name": "LYNFRED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "CA",
            "license": "20293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.