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Logan Primary Care

Physician Assistant in Herrin, IL · enumerated 2007 · authorized official Tara Deaton, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1194913541

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Registry record

Entity type Organization (Type 2)
Legal business name Logan Primary Care
Practice address 405 Rushing Dr, Herrin, IL, 62948
Phone (618) 993-3300
Fax (618) 997-6626
Enumeration date Oct 11, 2007
Last updated in NPPES Oct 11, 2007

Taxonomy & classification

363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers · License 85003043 (IL) Primary

Authorized official

Name Tara Deaton
Title Administrator
Phone (618) 993-3300

Other identifiers

Identifier Type State Issuer
P00166778 Other IL RAILROAD MEDICARE
094621 Other IL HEALTH ALLIANCE
143870 Medicaid IL -
10019630 Other IL BLUE CROSS BLUE SHIELD
657869 Other IL HEALTHLINK

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Logan Primary Care?
Logan Primary Care is registered in NPPES as a Physician Assistant (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2007-10-11.