MRS. KIMBERLY LACYNTHIA LOGAN APRN
NPI 1417147463
Nurse Practitioner - Family in Chatsworth, GA
About Mrs. Kimberly Lacynthia Logan Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KIMBERLY LACYNTHIA LOGAN APRN (NPI 1417147463) is an individual family provider in Chatsworth, Georgia, licensed in Florida (9166317) and active in the NPI registry since July 2007. She is enrolled in Medicare PECOS and is a graduate of Emory University School Of Medicine (1997).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Kimberly Lacynthia Logan Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Logan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Nashville, TN 37219
- Reassigned Medicare billing, Florida and Georgia enrollments
- 85 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30705 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Logan's NPI number?
The NPI number for Kimberly Logan is 1417147463. It was assigned to this individual provider in the NPPES registry on July 26, 2007. The provider is also known as Kimberly Laycinthia Stewart Aprn.
Where is Kimberly Logan located?
Kimberly Logan practices at 1440 Jackson Lake Rd, Chatsworth, GA 30705. The listed phone number is (904) 377-3301.
What is Kimberly Logan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kimberly Logan enrolled in Medicare?
Yes. Kimberly Logan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kimberly Logan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Logan reassigns Medicare benefits to Community Care Health Network LLC (Nashville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Logan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kimberly Logan was last updated on September 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Mrs. Kimberly Lacynthia Logan, APRN · NPI 1417147463
Family physician in Chatsworth, Georgia. Individual provider, active in the CMS NPPES registry since July 26, 2007.
## Identity
- **NPI:** 1417147463 (Entity type: Individual)
- **Enumerated:** July 26, 2007
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 9166317 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 1440 JACKSON LAKE RD, Chatsworth, GA 30705-4109
- **Phone:** (904) 377-3301
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Community Care Health Network LLC (NPI 1619368842, Nashville, TN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Emory University School Of Medicine, class of 1997
## Record status
- **NPPES last updated:** September 13, 2021
- **Other identifiers:** Medicaid 001458200 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1417147463) · Data from the CMS NPPES public registry.