Kelly J Logan (NPI# 1376592139, PAC ID# 6608930797) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1376592139 |
| PAC ID by PECOS | 6608930797 |
| Professional Enrollment ID | I20110613000529 |
| Full Name | Kelly J Logan |
| Address |
601 E 63rd St Suite 201 Kansas City MO 64110-3303 |
| Gender | F |
| Graduation Year | 2004 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Secondary Specialties | OSTEOPATHIC MANIPULATIVE MEDICINE, PAIN MANAGEMENT |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260193 | ST MARYS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 601 E 63rd St, Suite 201, Kansas City, MO 64110-3303 |
| Street Address |
601 E 63RD ST SUITE 201 |
| City | KANSAS CITY |
| State | MO |
| Zip | 64110-3303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer S Worth | Clinical Social Worker | 601 E 63rd St, 230 Worth It, Kansas City, MO 64110-3303 | |
| Jennifer C Lympus | Clinical Social Worker | 601 E 63rd St, 340 Brookside Counseling, Kansas City, MO 64110-3303 | |
| Sarah B Dominguez | Physical Therapy | Foundational Concepts Inc | 601 E 63rd St, Suite 230, Kansas City, MO 64110-3303 |
| Brenda L Willis | Clinical Social Worker | 601 E 63rd St, Suite 340, Kansas City, MO 64110-3303 | |
| Heather M Robinson | Clinical Social Worker | 601 E 63rd St, Suite 340, Kansas City, MO 64110-3303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Terry D Suppes | Family Medicine | Goppert Trinity Family Care LLC | 5151 Troost Ave, Suite 200, Kansas City, MO 64110-2524 |
| Michelle D Hart | Nurse Practitioner | Goppert Trinity Family Care LLC | 5151 Troost Ave, Suite 200, Kansas City, MO 64110-2524 |
| Brent A. Hrabik | Family Medicine | Goppert Trinity Family Care LLC | 5151 Troost Ave, Suite 200, Kansas City, MO 64110-2524 |
| Roland Sabates | Ophthalmology | 520 E 63rd St, Brookside Eye Care Center, Kansas City, MO 64110-3330 | |
| Gerhard W Cibis | Ophthalmology | 520 E 63rd St, Kansas City, MO 64110-3330 | |
| Susan J Brandt | Psychologist, Clinical | 633 E 63rd St, 240 Counseling Solutions, Kansas City, MO 64110-3331 | |
| Halima A Farah | Chiropractic | 751 E 63rd St, Suite 110, Kansas City, MO 64110-3361 | |
| David Clark Beckley | Chiropractic | 751 E 63rd St, Suite 110, Kansas City, MO 64110-3361 | |
| Vicki Cohen | Clinical Social Worker | Jewish Family Services | 425 E 63rd St, Kansas City, MO 64110-3386 |
| Lauren A Moret-glass | Clinical Social Worker | Jewish Family Services | 425 E 63rd St, Kansas City, MO 64110-3386 |
| Find all physicians in zip 64110 | |||
| City | KANSAS CITY |
| Zip Code | 64110 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | KANSAS CITY + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Kelly J Logan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.