LOGAN MEDICAL CLINIC
NPI 1619913613
Clinic/Center - Rural Health in Logan, KS

NPI Status: Active since June 20, 2006

Contact Information

214 W MAIN ST
LOGAN, KS
ZIP 67646
Phone: (785) 689-4220
Fax: (785) 689-4219

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  • Organization
  • Clinic/Center
  • Rural Health
  • CLIA Number: 17D0670033
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2026

About LOGAN MEDICAL CLINIC

This page provides the complete NPI Profile along with additional information for Logan Medical Clinic, a primary care provider established in Logan, Kansas operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1619913613 assigned on June 2006. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Logan Medical Clinic. The authorized official of this NPI record is Rhonda L Kellerman (Clinic Administrator)

NPI
1619913613
Provider Legal Name
PHILLIPS COUNTY HOSPITAL
Other Organization Name
LOGAN MEDICAL CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
214 W MAIN ST LOGAN, KS 67646
Location Phone
(785) 689-4220
Location Fax
(785) 689-4219
Mailing Address
214 W MAIN ST P.O. BOX 173 LOGAN, KS 67646
Mailing Phone
(785) 689-4220
Mailing Fax
(785) 689-4219
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-20-2006
Last Update Date
04-23-2015
Code Navigator

A primary care provider (PCP) like Logan Medical Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208D00000XAllopathic & Osteopathic Physicians

General Practice

0433764 (KS)
2363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

44437 (KS)

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RHONDA L KELLERMAN

Authorized Official Title
CLINIC ADMINISTRATOR
Authorized Official Phone
(785) 543-5211

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
178501MEDICARE OSCAR/CERTIFICATION (06)KS 
100409050CMEDICAID (05)KS 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
17D0670033
Facility Type
Physician Office
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
NANCY JOHNSON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Logan Medical Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for LOGAN MEDICAL CLINIC

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1619913613
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2629181662
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 2 + 9 + 1 + 8 + 1 + 6 + 6 + 2 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1619913613 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1285681619 MARYBETH VAN ROEKEL A.R.N.P.
Individual
Nurse Practitioner (Family)214 W MAIN ST
LOGAN, KS 67646
(785) 689-4220
1659724524NORTON COUNTY HOSPITAL
Organization
Clinic/Center (Primary Care)214 W MAIN ST
LOGAN, KS 67646
(785) 877-3351
1912673559 LINDSEY LEE JOHNSON APRN
Individual
Nurse Practitioner (Family)214 W MAIN ST
LOGAN, KS 67646
(785) 689-7464

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619913613, enumerated in the NPI registry as an "organization" on June 20, 2006

The provider is located at 214 W Main St Logan, Ks 67646 and the phone number is (785) 689-4220

This medical organization specializes in Clinic/Center with taxonomy code 261QR1300X with a focus in Rural Health

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 17D0670033 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on June 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.