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

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: November 01, 2026.

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

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 Presbyterian Medical Center, and maintains 2 additional practice locations.

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
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11215 Lee StCharlottesville, VA 22908-3055 · Phone (434) 924-9400
Location 2251 E Huron StChicago, IL 60611-3055 · Phone (312) 695-4447

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

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

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.

Medicare Billing Reassignments

3

Medicare enrollment records show Logan Jackson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mecklenburg Radiology Associates, P.A.
Same address
Diagnostic Radiology
3623 LATROBE DR, SUITE 216
Charlotte, NC 28211
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Mecklenburg Radiology Associates PA
  • 66 clinicians in this Medicare group
NPI 1295790657 (704) 332-1291
University Of Virginia Imaging, LLC
228 mi
Diagnostic Radiology
545 RAY C HUNT DR, STE 140
Charlottesville, VA 22903
  • Reassigned Medicare billing, Virginia enrollment
  • 308 clinicians in this Medicare group
NPI 1720233596 (434) 924-2567
University Of Virginia Physicians Group
233 mi
Neuromusculoskeletal Medicine, Sports Medicine
4105 LEWIS AND CLARK DR
Charlottesville, VA 22911
  • Reassigned Medicare billing, Virginia enrollment
  • 2,820 clinicians in this Medicare group
NPI 1033138250 (434) 295-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 5

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

Novant Health Presbyterian Medical Center

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340053
Location200 Hawthorne Lane Box 33549Charlotte, NC 28233 · Mecklenburg County
Emergency services Birthing friendly

Novant Health Matthews Medical Center

Acute Care Hospitals · Matthews, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340171
Location1500 Matthews Twnshp Prkwy Box 3310Matthews, NC 28106 · Mecklenburg County
Emergency services Birthing friendly

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

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)
3623 LATROBE DR STE 216
CHARLOTTE, NC 28211
Mecklenburg County (980) 208-1704
MATTHEW JAMES LOCKER MD
Radiology (Diagnostic Radiology)
3623 LATROBE DR STE 216
CHARLOTTE, NC 28211
Mecklenburg County (704) 332-1291
MR. ANDREW JOSEPH BOJANOWSKI PA-C
Physician Assistant
3623 LATROBE DR STE 216
CHARLOTTE, NC 28211
Mecklenburg County (704) 332-1291
DR. WILLIAM MICHAEL MCGARRY M.D.
Radiology (Diagnostic Radiology)
3623 LATROBE DR STE 216
CHARLOTTE, NC 28211
Mecklenburg County (704) 332-1291
MR. ANDREW SEWALISH PA-C
Physician Assistant
3623 LATROBE DR STE 216
CHARLOTTE, NC 28211
Mecklenburg County (704) 332-1291
ARAVIND SOMASUNDARAM
Radiology (Diagnostic Radiology)
3623 LATROBE DR STE 216
CHARLOTTE, NC 28211
Mecklenburg County (704) 332-1291
MR. CHADWICK GORDON ROGERS PA-C
Physician Assistant
3623 LATROBE DR STE 216
CHARLOTTE, NC 28211
Mecklenburg County (704) 332-1291
MARK S NOBLE PA
Physician Assistant
3623 LATROBE DR STE 216
CHARLOTTE, NC 28211
Mecklenburg County (980) 208-1704

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 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.

Where is Logan Jackson located?

Logan Jackson practices at 3623 Latrobe Dr Ste 216, Charlotte, NC 28211. The listed phone number is (704) 332-1291.

What is Logan Jackson's specialty?

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

Is Logan Jackson enrolled in Medicare?

Yes. Logan Jackson 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 organizations bill Medicare for Logan Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Logan Jackson reassigns Medicare benefits to 3 organizations: Mecklenburg Radiology Associates, P.A. (Charlotte, NC), University Of Virginia Imaging, LLC (Charlottesville, VA) and University Of Virginia Physicians Group (Charlottesville, VA). Each 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 Logan Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Logan Jackson accept?

Health plans from Cigna Healthcare list Logan Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Logan Jackson affiliated with any hospitals?

According to CMS data, Logan Jackson is affiliated with Novant Health Presbyterian Medical Center, Novant Health Matthews Medical Center, Novant Health Huntersville Medical Center, University Of Virginia Medical Center and Novant Health Uva Health System Culpeper Med Cente.

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 12 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.