Active NPI
Logan Memorial Hospital LLC
- Rural Acute Care Hospital
- Russellville, KY
National Provider Identifier
1992893416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Acute Care Hospital
- License
- 73
- Legal business name
- LOGAN MEMORIAL HOSPITAL LLC
- Practice address
- 1625 Nashville St
Russellville, KY 42276-8853 - Phone
- (270) 726-4011
- Fax
- (270) 726-7465
- NPI assigned
- Oct 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Johnetta Traylor
- Title
- Ao
- Phone
- (502) 596-6063
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Acute Care Hospital | 282NR1301X | 73 | KY | Primary |
Addresses
Primary practice location
1625 Nashville St
Russellville, KY 42276-8853
Mailing address
680 S 4TH St # KH-3
Louisville, KY 40202-2407
Phone (502) 596-6063
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5000013 | Other | KY | UNITED HEALTHCARE |
| 1096575 | Other | KY | PASSPORT HEALTH |
| 166291400 | Other | KY | ACS |
| 000000055027 | Other | KY | BLUE CROSS |
| 360698 | Other | KY | BLACK LUNG |
| 000000342028 | Other | KY | BLUE CROSS LABORATORY |
| 01000132 | Medicaid | KY | |
| 0180066 | Medicaid | TN | |
| 100038770A | Medicaid | IN | |
| KYMCO11B | Other | KY | WORKERS COMP |
Other names 1
- Logan Memorial Hospital
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | loganmemorial@yourcarecommunity.org |
National Provider Directory
National Provider DirectoryLocations
1623 Nashville St
Ste 101
Russellville, KY 42276
Phone (270) 725-4643
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Bowling Green, KY
- NPI 1821081779
-
- Family Nurse Practitioner
- Clarksville, TN
- NPI 1114911138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750723200000",
"number": "1992893416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 S 4TH ST # KH-3",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402022407",
"telephone_number": "502-596-6063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 NASHVILLE ST",
"city": "RUSSELLVILLE",
"state": "KY",
"postal_code": "422768853",
"telephone_number": "270-726-4011",
"fax_number": "270-726-7465"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOGAN MEMORIAL HOSPITAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-10",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A",
"authorized_official_last_name": "TRAYLOR",
"authorized_official_first_name": "JOHNETTA",
"authorized_official_title_or_position": "AO",
"authorized_official_telephone_number": "502-596-6063"
},
"taxonomies": [
{
"code": "282NR1301X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Rural",
"state": "KY",
"license": "73",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "5000013",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT HEALTH",
"identifier": "1096575",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS",
"identifier": "166291400",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000000055027",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLACK LUNG",
"identifier": "360698",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS LABORATORY",
"identifier": "000000342028",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01000132",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0180066",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100038770A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMP",
"identifier": "KYMCO11B",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "loganmemorial@yourcarecommunity.org",
"affiliation": "N",
"address_1": "1625 Nashville St",
"city": "Russellville",
"state": "KY",
"country_code": "US",
"postal_code": "422768853",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Logan Memorial Hospital",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Logan Memorial Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Russellville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.