1. Home
  2. Directory
  3. Idaho
  4. Boise
  5. Specialist Technologist
  6. NPI Profile

LOGAN ELLIS
NPI 1568900769
Specialist/Technologist - Athletic Trainer in Boise, ID

Active since February 08, 2017
703 S AMERICANA BLVD STE 120, BOISE, ID 83702(208) 489-5543 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Mar 17, 2018, Nov 14, 2017, Feb 8, 2017 (3 updates tracked since 2017).

About Logan Ellis NPPES

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

LOGAN ELLIS (NPI 1568900769) is an individual athletic trainer provider in Boise, Idaho, licensed in Idaho (AT-641) and active in the NPI registry since February 2017. He maintains a secondary practice location in Missoula.

NPPES Registry Identity

NPI1568900769
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameLOGAN ELLIS
Location Address703 S AMERICANA BLVD STE 120Boise, ID 83702-6754
Mailing Address9630 W Leo CtBoise, ID 83709-8250
Phone(208) 489-5543
Sole ProprietorYes
Enumeration DateFebruary 8, 2017
Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration
✔ NPI 1568900769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in ID · AT-641
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
703 S AMERICANA BLVD STE 120, Boise, ID 83702
Open in Google Maps ↗

Secondary Practice Location 1

Location 1520 W Spruce St Apt A203Missoula, MT 59802-4041 · Phone (503) 880-4532

Other Providers at the Same Location NPPES 4

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

EMILY ANNE FLANNERY MAL, LAT, ATC
Specialist/Technologist (Athletic Trainer)
703 S AMERICANA BLVD STE 120
BOISE, ID 83702
Ada County (208) 489-5543
TIN VUONG
Family Medicine (Sports Medicine)
703 S AMERICANA BLVD STE 120
BOISE, ID 83702
Ada County (208) 706-9340
DEREK DANIEL VANDERBURG PA-C
Physician Assistant
703 S AMERICANA BLVD STE 120
BOISE, ID 83702
Ada County (208) 706-2663
JOHN M WICK MD
Family Medicine
703 S AMERICANA BLVD STE 120
BOISE, ID 83702
Ada County (208) 894-5543

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 Logan Ellis's NPI number?

The NPI number for Logan Ellis is 1568900769. It was assigned to this individual provider in the NPPES registry on February 8, 2017.

Where is Logan Ellis located?

Logan Ellis practices at 703 S Americana Blvd Ste 120, Boise, ID 83702. The listed phone number is (208) 489-5543.

What is Logan Ellis's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Logan Ellis was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.