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LOGAN PRIMARY CARE
NPI 1992951123
Physician Assistant - Medical in Herrin, IL

Active since August 07, 2008
405 RUSHING DR, HERRIN, IL 62948(618) 993-3300(618) 993-0262 Get Directions Write a Review

NPPES record last updated: August 7, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Logan Primary Care NPPES

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

LOGAN PRIMARY CARE (NPI 1992951123) is a healthcare organization registered as a medical in Herrin, Illinois and active in the NPI registry since August 2008. The organization lists Micah Oakley, Physician Assistant, as its authorized official.

NPPES Registry Identity

NPI1992951123
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameLOGAN PRIMARY CARE
Location Address405 RUSHING DRHerrin, IL 62948-3730
Mailing Address405 Rushing DrHerrin, IL 62948-3730 · (618) 993-3300 · Fax (618) 993-0262
Phone(618) 993-3300
Fax(618) 993-0262
Organization SubpartNo
Authorized OfficialMicah OakleyPhysician Assistant · (618) 993-3300
Enumeration DateAugust 7, 2008
✔ NPI 1992951123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in IL · 085-003043
405 RUSHING DR, Herrin, IL 62948
Open in Google Maps ↗

Other Identifiers 8

Other10019630IL · Blue Cross Blue Shield
Medicare UPINC39531IL
Medicaid143870IL
Other033308IL · Health Alliance
Other033308IL · Healthlink
Other657869IL · Healthlink
Other080077375IL · Railroad Medicare
Medicare PIN336570IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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.

KRISTIN FRANCIS LCSW
Social Worker (Clinical)
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
DR. GOWDA SHARATH MD
Internal Medicine
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
LENORA ANN LEVIN
Social Worker (Clinical)
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
LESLIE ANN HICKMAN NP
Nurse Practitioner
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
LOGAN PRIMARY CARE
Physician Assistant
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
KALLIE M FRENCH PAC
Physician Assistant
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
LAURA UTLEY APN
Nurse Practitioner
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
VICTORIA DARE NP
Nurse Practitioner
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300

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 Primary Care's NPI number?

The NPI number for Logan Primary Care is 1992951123. It was assigned to this organization in the NPPES registry on August 7, 2008.

Where is Logan Primary Care located?

Logan Primary Care is located at 405 Rushing Dr, Herrin, IL 62948. The listed phone number is (618) 993-3300.

What is Logan Primary Care's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Logan Primary Care was last updated on August 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.