JORDAN LOGAN N.P.
NPI 1184053324
Nurse Practitioner - Psychiatric/Mental Health in Boulder, CO

Q: What is Jordan Logan's NPI number?

The NPI number for Jordan Logan is 1184053324. It was assigned to this individual provider in the NPPES registry on November 7, 2013.

Q: What is Jordan Logan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: Is Jordan Logan enrolled in Medicare?

No. Jordan Logan has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jordan Logan was last updated on January 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 07, 2013Opted out of Medicare · through Jul 1, 2028

4150 DARLEY AVE STE 6, BOULDER, CO 80305(303) 720-6581(303) 569-6069 Get Directions Write a Review

NPPES record last updated: January 7, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Jordan Logan N.p. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN LOGAN N.P. (NPI 1184053324) is an individual psychiatric/mental health provider in Boulder, Colorado, licensed in Colorado (APN.0991445-NP) and active in the NPI registry since November 2013. He has opted out of Medicare through July 1, 2028.

NPPES Registry Identity

NPI1184053324

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameJORDAN LOGANCredential: N.P.

Location Address4150 DARLEY AVE STE 6Boulder, CO 80305-6537

Mailing Address4150 Darley Ave Ste 6Boulder, CO 80305-6537 · (303) 720-6581 · Fax (303) 569-6069

Phone(303) 720-6581

Fax(303) 569-6069

Sole ProprietorYes

Enumeration DateNovember 7, 2013

Last NPPES UpdateJanuary 7, 2022

NPPES CertifiedJanuary 7, 2022

✔ NPI 1184053324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CO · APN.0991445-NP

Also ListedRegistered NurseTaxonomy 163W00000X · License 0190438 (CO)

4150 DARLEY AVE STE 6, Boulder, CO 80305

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Jordan Logan N.p. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2026 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2026

Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INNER RADIANCE LLC

Community/Behavioral Health