Individual provider Active NPI

Kameron Logan, DC

  • Chiropractor
  • Huntersville, NC
National Provider Identifier
1982368197
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5380 Issued in NC
Practice address
202 S Old Statesville Rd Ste a
Huntersville, NC 28078-9700
Phone
(704) 954-8036
NPI assigned
Oct 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5380 NC Primary

Addresses

Primary practice location

202 S Old Statesville Rd Ste a
Huntersville, NC 28078-9700

Mailing address

6401 Pamela St
Huntersville, NC 28078-6318

Other practice location 1

7918 Rea Rd Ste B
Charlotte, NC 28277-6575
Phone (704) 769-2520

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221206000438 NC Practitioner - Chiropractic 9032588561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gys Chiro IncGroup PAC ID 9133146541, 8 clinicians

Practice addresses (Care Compare)

2200 Randolph Rd
Charlotte, NC 28207-1126
Phone (704) 372-9292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5380NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gys Chiro Inc Chiropractor CurrentSince Apr 24, 2023 Accepting new patients

Locations

2200 Randolph Rd
Ste B
Charlotte, NC 28207
Phone (704) 372-9292

2200 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-9292

3410 W Wendover Ave
Ste A
Greensboro, NC 27407
Phone (336) 274-3500

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": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1982368197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 PAMELA ST",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S OLD STATESVILLE RD STE A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789700",
            "telephone_number": "704-954-8036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7918 Rea Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282776575",
            "country_code": "US",
            "telephone_number": "704-769-2520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "KAMERON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.