LOGAN J JACKSON MD
NPI 1740817261
Radiology - Diagnostic Radiology in Charlotte, NC

Q: What is Logan Jackson's NPI number?

The NPI number for Logan Jackson is 1740817261. It was assigned to this individual provider in the NPPES registry on March 25, 2020.

Q: What is Logan Jackson's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Logan Jackson was last updated on November 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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 March 25, 2020PECOS EnrolledAccepts Medicare Assignment

3623 LATROBE DR STE 216, CHARLOTTE, NC 28211(704) 332-1291 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 3, 2025, Jun 30, 2025, Jun 30, 2021 and 2 more (5 updates tracked since 2020).

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About Logan J Jackson Md NPPES

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

LOGAN J JACKSON MD (NPI 1740817261) is an individual diagnostic radiology provider in Charlotte, North Carolina, licensed in North Carolina (2025-03621) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with Novant Health Huntersville Medical Center, and is a graduate of Medical University Of South Carolina College Of Medicine (2020).

NPPES Registry Identity

NPI1740817261

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameLOGAN J JACKSONCredential: MD

Location Address3623 LATROBE DR STE 216Charlotte, NC 28211-2117

Mailing AddressPo Box 221249Charlotte, NC 28222-1249 · (704) 332-1291

Phone(704) 332-1291

Sole ProprietorNo

Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 2020

Enumeration DateMarch 25, 2020

Last NPPES UpdateNovember 3, 20255 updates tracked since enumeration

NPPES CertifiedNovember 3, 2025

✔ NPI 1740817261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Licenses✔ Licensed in NC · 2025-03621✔ Licensed in VA · 0101285232✔ Licensed in IL · 125077323

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License LL84285 (SC)

3623 LATROBE DR STE 216, Charlotte, NC 28211

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Logan J Jackson Md 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.

PECOS PAC ID2466875018

PECOS Enrollment IDI20250402003393

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Novant Health Huntersville Medical Center

Acute Care Hospitals · Huntersville, NC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340183

Location10030 Gilead RoadHuntersville, NC 28078 · Mecklenburg County

Emergency services Birthing friendly

University Of Virginia Medical Center

Acute Care Hospitals · Charlottesville, VA

4/5 CMS rating

OwnershipGovernment - State

CMS Certification Number490009

Location1215 Lee StreetCharlottesville, VA 22908 · Charlottesville City County

Emergency services Birthing friendly

Novant Health Uva Health System Culpeper Med Cente

Acute Care Hospitals · Culpeper, VA

1/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number490019

Location501 Sunset LaneCulpeper, VA 22701 · Culpeper County

Emergency services Birthing friendly

Novant Prince William Medical Center

Acute Care Hospitals · Manassas, VA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490045

Location8700 Sudley RdManassas, VA 20110 · Manassas City County

Emergency services Birthing friendly

Uva Health Haymarket Medical Center

Acute Care Hospitals · Haymarket, VA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490144

Location15225 Healthcote BoulevardHaymarket, VA 20169 · Prince William County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28211 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

WHITNEY FELTUS M.D.

Radiology (Diagnostic Radiology)