LOGAN GRADDY MD PLLC (NPI# 1275967077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275967077 |
| Entity Type | Organization |
| Organization Name | LOGAN GRADDY MD PLLC |
| Practice Address |
910 Broad St Durham NC 27705-4142 |
| Practice Telephone | 9194164191 |
| Practice Fax Number | 8888056175 |
| Mailing Telephone | 9194164191 |
| Mailing Fax Number | 8888056175 |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2013-08-28 |
| Authorized Official Name | DR. LOGAN GRADDY (OWNER) |
| Authorized Official Telephone | 9194759160 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
2007000070 | NC | Ambulatory Health Care Facilities |
| Street Address |
910 BROAD ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-4142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992847412 | James Walter Finch | Family Medicine | 910 Broad St, Durham, NC 27705-4142 | 2007-02-12 |
| 1386153989 | Jamie C Rincker | Dietitian, Registered | 910 Broad St, Durham, NC 27705-4142 | 2017-09-26 |
| 1326356635 | Shana Monique Williams | Nurse Practitioner | 910 Broad St, Durham, NC 27705-4142 | 2010-09-21 |
| 1407162050 | Kathryn Wriggelsworth | Nurse Practitioner | 910 Broad St, Durham, NC 27705-4142 | 2010-08-20 |
| 1932377280 | Logan Gabriel Graddy | Psychiatry & Neurology | 910 Broad St, Durham, NC 27705-4142 | 2008-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455991 | Buckeye Psychology Pllc | Clinic/Center | 1310 Fenwick Pkwy, Durham, NC 27713-5829 | 2020-10-26 |
| 1265072698 | Markovits Counseling, Pllc | Clinic/Center | 3622 Lyckan Pkwy Unit Unit5007, Durham, NC 27707-2564 | 2020-01-14 |
| 1649766221 | Pathways To Healing, Pllc | Clinic/Center | 3622 Lyckan Pkwy Ste 3008a, Durham, NC 27707-2566 | 2018-07-06 |
| 1871084475 | Potter Counseling & Consulting, Pllc | Clinic/Center | 1921 N Pointe Dr Ste 280, Durham, NC 27705-2672 | 2018-05-21 |
| 1629581137 | Linda A Guttman Psy D Pllc | Clinic/Center | 13 Jenkins Court, Suite 230a, Durham, NH 03824-2917 | 2017-11-07 |
| 1073042768 | Therapy Services for Families PC | Clinic/Center | 1502 W Nc Highway 54 Ste 505, Durham, NC 27707-5599 | 2017-06-07 |
| 1649686221 | Nc Christian Counselor | Clinic/Center | 2031 W Club Blvd, Durham, NC 27705-3209 | 2014-07-03 |
| 1689815334 | Full Potential Behavioral Health Care, Inc. | Clinic/Center | 1530 N Gregson St Ste 3-d, Durham, NC 27701-1155 | 2009-03-10 |
| 1053595611 | Burke Facilities II, LLC | Clinic/Center | 4 Onyx Ct, Durham, NC 27703-2680 | 2007-12-19 |
| 1790803898 | El Futuro, Inc | Clinic/Center | 2020 Chapel Hill Rd., Suite 23, Durham, NC 27707 | 2007-03-27 |
| Find all providers in DURHAM | ||||
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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.