Logan Primary Care
Logan Primary Care is a healthcare organization registered as Primary Care Nurse Practitioner in Herrin, IL, holding Type 2 (organization) NPI 1902094352 since 2007. The authorized official on file is Tara Deaton, Administrator.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1902094352 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Logan Primary Care |
| Practice address | 405 RUSHING DR, Herrin, IL, 62948 |
| Phone | 6189933300 |
| Fax | 6189323797 |
| Enumeration date | 2007-10-11 |
| Last updated in NPPES | 2007-10-11 |
Authorized official
| Name | Tara Deaton |
|---|---|
| Title | Administrator |
| Phone | 6189973400 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 363LP2300X | Primary Care Nurse Practitioner | Primary | — | IL |
Copy-ready billing details
Provider: Logan Primary Care NPI: 1902094352 Taxonomy: 363LP2300X (Primary Care Nurse Practitioner) Address: 405 RUSHING DR, Herrin, IL, 62948
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1508846429 | Shannon Rider | Individual | Internal Medicine Physician | Herrin, IL |
| 1821102849 | Mark Korte | Individual | Family Medicine Physician | Herrin, IL |
| 1891809810 | Russell Brown | Individual | Family Medicine Physician | Herrin, IL |
| 1396859328 | Anna Anderson | Individual | Physician Assistant | Herrin, IL |
| 1497869440 | Robin Gallo | Individual | Physician Assistant | Herrin, IL |
| 1730296880 | Logan Primary Care Service Corporation | Organization | Rural Health Clinic/Center | Herrin, IL |
| 1831264639 | Ida Hess | Individual | Nurse Practitioner | Herrin, IL |
| 1841344876 | Pramote Anantachai | Individual | Internal Medicine Physician | Herrin, IL |
Verify this record
Cross-check NPI 1902094352 against the authoritative CMS record: view Logan Primary Care on the official NPPES registry .
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. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Logan Primary Care?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-10-11.