LOGAN DARYL PROFFITT (NPI# 1063041358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063041358 |
| Entity Type | Individual |
| Full Name | LOGAN DARYL PROFFITT |
| Credential | DO |
| Practice Address |
1107 E 66th St Savannah GA 31404-5701 |
| Practice Telephone | 9123508404 |
| Mailing Telephone | 9123508404 |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1107 E 66TH ST |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-5701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275552143 | Robert M. Pallay | Family Medicine | 1107 E 66th St, Savannah, GA 31404-5701 | 2006-07-19 |
| 1407475478 | Max Needham | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2020-04-10 |
| 1629697636 | Megan Sando Dannemiller | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2020-04-09 |
| 1215566559 | Alexis Brown | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2020-04-08 |
| 1720616949 | Catherine Waldron | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2020-04-01 |
| 1821626565 | Victoria Elise Mazzella | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2020-03-30 |
| 1699235044 | John Gunnar Magnuson | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2019-03-21 |
| 1992264907 | Sophia Elias | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2019-03-19 |
| 1669931598 | Khaja Kamal Mohiuddin | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2019-03-19 |
| 1992283972 | Ashley H Hawes | Student in an Organized Health Care Education/Training Program | 1107 E 66th St, Savannah, GA 31404-5701 | 2018-08-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962042556 | Pooja Vinay Patel | Student in an Organized Health Care Education/Training Program | 1 Harvest Ln, Savannah, GA 31411-2116 | 2020-01-10 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1629541818 | Brittany Sue Walker | Student in an Organized Health Care Education/Training Program | 10 Rivermist Ln, Savannah, GA 31410-2524 | 2019-01-10 |
| 1548737786 | John Thomas Muller | Student in an Organized Health Care Education/Training Program | 120 Brompton Rd, Savannah, GA 31410-3183 | 2018-10-25 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1043718877 | Alexa Coscia | Student in an Organized Health Care Education/Training Program | 505 Mall Blvd Apt 103, Savannah, GA 31406-4855 | 2018-01-26 |
| 1093240343 | Kimberly Tarver | Student in an Organized Health Care Education/Training Program | 4200 Waters Ave, Savannah, GA 31404-6214 | 2017-04-25 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| Find all providers in SAVANNAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.