BRENT JUSTIN LOGAN (NPI# 1619166253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619166253 |
| Entity Type | Individual |
| Full Name | BRENT JUSTIN LOGAN |
| Credential | MD |
| Practice Address |
1814 Westchester Dr Ste. 203 High Point NC 27262-7299 |
| Mailing Address |
1701 Westchester Dr Ste. 8502 High Point NC 27262-7008 |
| Practice Telephone | 3368022100 |
| Practice Fax Number | 3368022101 |
| Mailing Telephone | 3368022400 |
| Mailing Fax Number | 3368022534 |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2016-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 2007-01471 | NC | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 50417 | TN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 0101254581 | VA | Allopathic & Osteopathic Physicians |
| N | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
0101254581 | VA | Allopathic & Osteopathic Physicians |
| N | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
50417 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
1814 WESTCHESTER DR STE. 203 |
| City | HIGH POINT |
| State | NC |
| Zip Code | 27262-7299 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518965524 | Alehegn Asres | Family Medicine | 1814 Westchester Dr, Suite 301, High Point, NC 27262-7299 | 2005-07-13 |
| 1386169266 | Lena Ee | Nurse Practitioner | 1814 Westchester Dr, High Point, NC 27262-7299 | 2017-08-11 |
| 1003365321 | Kinsley C Coley | Physician Assistant | 1814 Westchester Dr, Suite 101, High Point, NC 27262-7299 | 2016-09-28 |
| 1336503036 | Vincent J Costella | Physician Assistant | 1814 Westchester Dr, Ste. 301, High Point, NC 27262-7299 | 2016-04-08 |
| 1982062758 | Teah Nakesha Shante' Doles-johnson | Nurse Practitioner | 1814 Westchester Dr, Ste 301, High Point, NC 27262-7299 | 2016-02-08 |
| 1831567445 | Cornerstone Health Care, LLC | Internal Medicine | 1814 Westchester Dr, Ste 302, High Point, NC 27262-7299 | 2015-09-14 |
| 1124495353 | Christi Fields Morgan | Nurse Practitioner | 1814 Westchester Dr, Ste 301, High Point, NC 27262-7299 | 2015-08-24 |
| 1508250523 | Jennifer M Burnette | Physician Assistant | 1814 Westchester Dr, Suite 101, High Point, NC 27262-7299 | 2015-03-27 |
| 1760887640 | Cornerstone Health Care Pa | Non-Pharmacy Dispensing Site | 1814 Westchester Dr, Suite 301, High Point, NC 27262-7299 | 2014-11-04 |
| 1194133108 | Brittany N Axner | Physician Assistant | 1814 Westchester Dr, Suite 101, High Point, NC 27262-7299 | 2014-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821623620 | Lane and Associates Xxxviii Dds Pa | Dentist | 101 Northpoint Avenue, High Point, NC 27262 | 2020-03-12 |
| 1043869936 | Norma Mechelle Cox | Technician | 1145 Hawick Dr, High Point, NC 27262 | 2019-09-04 |
| 1417514910 | Jennifer A. Loveland Dmd II Pllc | Dentist | 1007 Phillips Avenue, Suite 103, High Point, NC 27262 | 2019-05-21 |
| 1982175196 | World Relief Corp of National Association of Evangelicals | Marriage & Family Therapist | 155 Northpoint Avenue, Suite 102, High Point, NC 27262 | 2018-12-16 |
| 1538679907 | Zackary Daniel Rogers | Physician Assistant | 1814 Westchester Dr #301, High Point, NC 27262 | 2017-10-11 |
| 1184164162 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2005 N Main St., Suite 101, High Point, NC 27262 | 2017-02-24 |
| 1225483951 | Randall Godette | Physician Assistant | 611 Lindsay Street, High Point, NC 27262 | 2016-05-02 |
| 1336537356 | Optics, Inc. | Durable Medical Equipment & Medical Supplies | 1105 Lindsay Street, High Point, NC 27262 | 2014-12-29 |
| 1871902346 | Isha Bangura | Counselor | 910 Mill Ave., High Point, NC 27262 | 2014-08-08 |
| 1831478833 | Jenny Susan Mason | Specialist/Technologist | 922 West College Dr, High Point, NC 27262 | 2011-08-08 |
| Find all providers in zip 27262 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407355704 | Triad Pediatrics, PC | Pediatrics | 2754 Hwy 68, Suite 111, High Point, NC 27265 | 2018-02-02 |
| 1326400839 | Janie Christine Ogle | Pediatrics | 2754 Nc- 68 N, Suite 111, High Point, NC 27265-0298 | 2016-03-23 |
| 1992005805 | Community Connections Family Life Center LLC | Pediatrics | 622 N Hamilton St, Suite 104, High Point, NC 27262-4076 | 2010-10-26 |
| 1922198977 | High Point Pediatrics | Pediatrics | 404 Westwood Ave Ste 103, High Point, NC 27262 | 2006-10-13 |
| 1922010768 | David R Olson | Pediatrics | 2754 Nc Highway 68 S Ste 111, High Point, NC 27265 | 2006-08-12 |
| 1679595995 | Anne Lule-kiwanuka | Pediatrics | 1300 N University Pkwy, High Point, NC 27262-3456 | 2006-07-24 |
| 1043257231 | Gregory Carl Ellis | Pediatrics | 1224 Eastchester Dr, High Point, NC 27265-3116 | 2006-05-31 |
| 1982687117 | Jessica Vandeven | Pediatrics | 2754 Nc-68, Suite 111, High Point, NC 27265 | 2005-11-22 |
| 1467451187 | Easwar Ramadoss | Pediatrics | 624 Quaker Ln Ste 200d, High Point, NC 27262-3800 | 2005-07-14 |
| 1366447807 | Amy H Eubanks | Pediatrics | 1701 Westchester Dr, Suite 850, High Point, NC 27262-7008 | 2005-06-20 |
| Find all providers in HIGH POINT | ||||
| City | HIGH POINT |
| Zip Code | 27262 |
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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.