Active NPI
Logan James Neuhauser, DO
- Infectious Disease Physician
- Grand Rapids, MI
National Provider Identifier
1992455141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 5101028700
- Practice address
- 230 Michigan St NE
Grand Rapids, MI 49503-2550 - Phone
- (616) 774-2822
- Fax
- (616) 391-8665
- NPI assigned
- Mar 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Infectious Disease Physician | 207RI0200X | 5101028700 | MI | Primary |
Addresses
Primary practice location
230 Michigan St NE
Grand Rapids, MI 49503-2550
Mailing address
230 Michigan St NE
Grand Rapids, MI 49503-2550
Phone (616) 774-2822
Other practice location 1
310 Lafayette Ave SE Ste 410
Grand Rapids, MI 49503-4693
Phone (616) 774-2822
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220709000673 | IN | Order and Referring Only - Infectious Disease | 4981084886 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101028700 | MI | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751328000000",
"number": "1992455141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 MICHIGAN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032550",
"telephone_number": "616-774-2822",
"fax_number": "616-391-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 MICHIGAN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032550",
"telephone_number": "616-774-2822",
"fax_number": "616-391-8665"
}
],
"practiceLocations": [
{
"address_1": "310 Lafayette Ave SE Ste 410",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495034693",
"country_code": "US",
"telephone_number": "616-774-2822",
"fax_number": "616-391-8665",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NEUHAUSER",
"first_name": "LOGAN",
"middle_name": "JAMES",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-28",
"last_updated": "2025-07-01",
"certification_date": "2025-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "MI",
"license": "5101028700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.