Organization Active NPI

Logan Family Chiropractic & Rehabilitation Center

  • Chiropractor
  • Logan, OH
National Provider Identifier
1982804175
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3158 Issued in OH
Legal business name
LOGAN FAMILY CHIROPRACTIC & REHABILITATION CENTER
Practice address
751 State Route 664 N Unit D
Logan, OH 43138-9250
Phone
(740) 385-4141
Fax
(740) 385-3838
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Authorized official

Name
Dr. Christian Ernest Gedeon, D.C.NPI 1750464400
Title
Doctor of Chiropractic
Phone
(740) 385-4141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3158 OH Primary

Addresses

Primary practice location

751 State Route 664 N Unit D
Logan, OH 43138-9250

Mailing address

PO Box 29
Logan, OH 43138-1831
Phone (740) 385-4141

Other identifiers 1

IdentifierTypeStateIssuer
2314070MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051213000419 OH Part B Supplier - Clinic/Group Practice 8325069768 Receives reassigned benefits from 1 practitioner
Practice locations: Logan, OH

National Provider Directory

National Provider Directory

Locations

12886 Grey St
Logan, OH 43138
Phone (740) 380-6124

12866 Grey St
Logan, OH 43138
Phone (740) 385-4141

383 W Front St
Logan, OH 43138
Phone (740) 385-4141

751 State Route 664 N
Unit D
Logan, OH 43138
Phone (740) 385-4141

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1982804175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431381831",
            "telephone_number": "740-385-4141",
            "fax_number": "740-385-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 STATE ROUTE 664 N UNIT D",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431389250",
            "telephone_number": "740-385-4141",
            "fax_number": "740-385-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN FAMILY CHIROPRACTIC & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "GEDEON",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "740-385-4141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2314070",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.