South Logan Medical Management SVCS LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SOUTH LOGAN MEDICAL MANAGEMENT SVCS LLC

Practice address

895 S Logan St
Denver, CO 80209-4127

Phone

(303) 733-3764

Fax

(303) 733-3764

NPI assigned

Oct 23, 2014

Organization subpart

No

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

Authorized official

Name

Georgette V Laws-Willis, PR

Title

Office Manager

Phone

(303) 733-3764

Specialties & licenses 1

Addresses

Other names 1

• South Logan Family Practice Former legal business name

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1992100622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 S LOGAN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094127",
            "telephone_number": "303-733-3764",
            "fax_number": "303-733-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 S LOGAN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094127",
            "telephone_number": "303-733-3764",
            "fax_number": "303-733-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LOGAN MEDICAL MANAGEMENT SVCS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "LAWS-WILLIS",
        "authorized_official_first_name": "GEORGETTE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "303-733-3764",
        "authorized_official_credential": "PR"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Logan Family Practice",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• South Federal Dental GP PC
• South Federal Dental Partners PLLC
• South Federal Family Practice
• South Logan Family Practice
• South Logan Family Practice Center
• South Valley Physical Therapy PC
• Southbridge Partners II
• Southeast Dental Arts LLC
• Southeast Dental Arts,LLC
• Southeast Denver Dental Associates PC

• Health Service Clinic/Center in Denver, CO
• Providers in Denver, CO by specialty
• Health Service Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.