LOGAN T MAHLOCK (NPI# 1396259867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396259867 |
| Entity Type | Individual |
| Full Name | LOGAN T MAHLOCK |
| Practice Address |
4364 Scorpius St Orlando FL 32816 |
| Mailing Address |
1 Tiger Dr Marshall TX 75670-1412 |
| Practice Telephone | 4078232000 |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2018-07-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT7560 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BOARD OF CERTIFICATION | 2000032233 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4364 Scorpius St, Orlando, FL 328168035 | 4078232000 |
| Street Address |
4364 SCORPIUS ST |
| City | ORLANDO |
| State | FL |
| Zip Code | 32816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063031854 | Jessica Harris | Specialist/Technologist | 4364 Scorpius St, Orlando, FL 32816-1180 | 2020-04-11 |
| 1811456072 | Chanel Kerlena Cynthia Hamilton | Student in an Organized Health Care Education/Training Program | 4364 Scorpius St, Orlando, FL 32816-8035 | 2019-03-18 |
| 1407315484 | Destiny Glass | Specialist/Technologist | 4364 Scorpius St, Orlando, FL 32816-8035 | 2019-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225667934 | Zamaris Rivera | Student in an Organized Health Care Education/Training Program | 12805 Pegasus Drive, Room 123, Orlando, FL 32816 | 2020-04-04 |
| 1609398064 | Micaela Breann Ward | Student in an Organized Health Care Education/Training Program | 4266 West Plaza Drive, Orlando, FL 32816 | 2017-07-07 |
| 1427178276 | Ordella Georgette Hawkins | Nurse Practitioner | 4098 Libra Dr, Orlando, FL 32816 | 2007-03-29 |
| 1346398021 | Kelly Ann Roberts | Family Medicine | 4098 Libra Dr, Orlando, FL 32816 | 2007-01-08 |
| 1407463508 | Michelle A Trak | Student in an Organized Health Care Education/Training Program | 2201 Research Parkway Suite 300, Orlando, FL 32816-0001 | 2020-09-23 |
| 1891330262 | Karly Branch | Psychologist | 4090 Libra Dr Ucf Counseling & Psychological Services, Orlando, FL 32816-0001 | 2019-11-08 |
| 1164994885 | Amie R Newins | Psychologist | 4111 Pictor Lane Psychology Building Suite 320, Orlando, FL 32816-0001 | 2018-12-19 |
| 1942795489 | Alexandra Carvajal | Specialist/Technologist | 4000 Central Blvd, Orlando, FL 32816-0001 | 2018-06-27 |
| 1427579069 | Zya'nel Moorehead-mckie | Student in an Organized Health Care Education/Training Program | 4000 University Blvd, Orlando, FL 32816-0001 | 2017-07-05 |
| 1275072142 | Diane Gail Meadows | Nurse Practitioner | 4800 Central Florida Blvd, Orlando, FL 32816-0001 | 2017-02-13 |
| Find all providers in zip 32816 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770182651 | Sarah Danielle Combs | Specialist/Technologist | 4521 Lenmore Street, Orlando, FL 32812 | 2020-10-21 |
| 1861003501 | Zuzanna Barbara Maciejewska | Specialist/Technologist | 11172 Point Sylvan Cir Apt 29c, Orlando, FL 32825-6046 | 2020-08-16 |
| 1457960312 | Chris Gadah | Specialist/Technologist | 12340 Boggy Creek Rd, Orlando, FL 32824-6902 | 2020-07-27 |
| 1831716141 | Kelley April Gosling | Specialist/Technologist | 3829 Winding Lake Cir, Orlando, FL 32835-2655 | 2020-07-02 |
| 1801425806 | Brittney Marie Webb | Specialist/Technologist | 2475 Abalone Blvd, Orlando, FL 32833-3966 | 2020-04-02 |
| 1538707989 | Alan Bradley Zemel | Specialist/Technologist | 368 Lakeview St, Orlando, FL 32804-6882 | 2019-12-17 |
| 1003461948 | Jason Kirkman | Specialist/Technologist | 10402 Glassborough Dr, Orlando, FL 32825-5924 | 2019-08-07 |
| 1396399846 | Steven Outlaw | Specialist/Technologist | 216 Spencer St, Orlando, FL 32839 | 2019-08-01 |
| 1427600188 | Samuel G Winters | Specialist/Technologist | 5818 Petunia Ln, Orlando, FL 32821-5511 | 2019-07-12 |
| 1922563428 | Lindsay Perrin | Specialist/Technologist | 4058 Teriwood Ave, Orlando, FL 32812-7946 | 2019-02-08 |
| Find all providers in ORLANDO | ||||
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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.