LOGAN NICHOLS (NPI# 1871062125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871062125 |
| Entity Type | Individual |
| Full Name | LOGAN NICHOLS |
| Credential | PA-C |
| Practice Address |
865 N Arizola Rd Casa Grande AZ 85122-6011 |
| Mailing Address |
762 E Chicago St Chandler AZ 85225-9420 |
| Practice Telephone | 5208363446 |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2019-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 7343 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
865 N ARIZOLA RD |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85122-6011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407859416 | Jeannette Vaughn-dotterer | Physician Assistant | 865 N Arizola Rd, Casa Grande, AZ 85222-6011 | 2005-05-23 |
| 1215538533 | Jeffrey Andrew Asman | Pharmacist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2020-11-03 |
| 1558960740 | Sharon Lyndell Goettsch | Dental Hygienist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2020-10-20 |
| 1447858899 | Paul Asimah Kwofie | Dental Hygienist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2020-10-16 |
| 1568077550 | Ann Kelly Truong | Pharmacist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2020-09-15 |
| 1518575877 | Travis William Warman | Pharmacist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2020-07-22 |
| 1851935415 | Briona Perry | Pharmacist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2019-11-06 |
| 1366098030 | Megan Jo Kilgore | Pharmacist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2019-08-17 |
| 1073168803 | Brian Maniga | Pharmacist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2019-08-08 |
| 1972155414 | Travis Hogan | Dentist | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2019-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1063060291 | Martha Bollin | Registered Nurse | 2631 N. Brown Ave., Casa Grande, AZ 85122 | 2019-08-30 |
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1629532692 | Kirk Lee Mackley | Physical Therapist | Vibrant Care, 1355 E Florence Blvd #137, Casa Grande, AZ 85122 | 2019-01-24 |
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1710455860 | Community Intervention Associates, Inc | Clinic/Center | 1667 N. Trekell Rd, Suite 101 & 102, Casa Grande, AZ 85122 | 2018-11-07 |
| 1245728302 | Jenkins Chiropractic LLC | Chiropractor | 1891 N Trekell Rd Ste 2, Casa Grande, AZ 85122 | 2018-04-24 |
| 1497242408 | Kelly Winnett | Naturopath | 1415 N Trekell Rd Ste 102, Casa Grande, AZ 85122 | 2018-04-16 |
| 1851895783 | Michael Brubaker Counseling | Community/Behavioral Health | 1927 N. Trekell Rd, Ste D, Casa Grande, AZ 85122 | 2018-03-23 |
| 1770095317 | Walmart Stores Inc. | Pharmacy | 1741 E. Florence Blvd, Casa Grande, AZ 85122 | 2017-11-03 |
| Find all providers in zip 85122 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1356329379 | Kelly D Chavez | Physician Assistant | 1729 N Trekell Rd, Suite 124, Casa Grande, AZ 85222 | 2006-01-09 |
| 1407859416 | Jeannette Vaughn-dotterer | Physician Assistant | 865 N Arizola Rd, Casa Grande, AZ 85222-6011 | 2005-05-23 |
| 1073110722 | Danielle Laurice Stewart | Physician Assistant | 560 N Camino Mercado Ste 7, Casa Grande, AZ 85122-5759 | 2020-10-06 |
| 1689111957 | Abel Ortega Diaz | Physician Assistant | 865 N Arizola Rd, Casa Grande, AZ 85122 | 2017-01-25 |
| 1467853630 | Sara Diane Gordoa | Physician Assistant | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2014-09-08 |
| 1265864359 | Bret Lee Jacobsen Miller | Physician Assistant | 1800 E Florence Blvd, Ste 139, Casa Grande, AZ 85122-5303 | 2013-07-31 |
| 1821306804 | Samantha Louise Sheire | Physician Assistant | 1637 E Monument Plaza Cir, Suite 1, Casa Grande, AZ 85122-5638 | 2010-09-23 |
| 1255560710 | Vincent J Tapia | Physician Assistant | 1637 E Monument Plaza Cir, Casa Grande, AZ 85222-5600 | 2009-07-06 |
| 1285828053 | Cynthia Price Franco | Physician Assistant | 1890 E Florence Blvd, Ste 4, Casa Grande, AZ 85122-5642 | 2007-09-05 |
| Find all providers in CASA GRANDE | ||||
| City | CASA GRANDE |
| Zip Code | 85122 |
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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.