| Mr Michael Stephen Logue, FAM NRS PRAC FNP | |
|
10012 Kennerly Road, Suite # 301, St Louis, MO 63128 | |
| (314) 894-0787 | |
| (314) 729-1489 |
| Full Name | Mr Michael Stephen Logue |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 24 Years |
| Location | 10012 Kennerly Road, St Louis, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750338919 | NPI | - | NPPES |
| 072289 | Other | MO | EXCLUSIVE CHOICE |
| 356650631001 | Medicaid | IL | |
| 7196539 | Other | MO | AETNA |
| 189482 | Other | MO | BCBS |
| 46286 | Other | MO | HEALTHCARE USA |
| P00117390 | Other | MO | MEDICARE RAILROAD |
| 429176605 | Medicaid | MO | |
| 652432 | Other | MO | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 135879 (Missouri) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 209004468 (Illinois) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Hospital | Chesterfield, MO | Hospital |
| Mercy Hospital South | Saint louis, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Heart Care Specialists Llc | 2062774755 | 16 |
| Heart Health Specialists, Llc | 3779727565 | 10 |
| Cardiac Specialists Of St Lukes Llc | 6709810880 | 8 |
| Entity Name | Cardiac Specialists of St Lukes LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285691063 PECOS PAC ID: 6709810880 Enrollment ID: O20050920000114 |
| Entity Name | Heart Health Specialists, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053756296 PECOS PAC ID: 3779727565 Enrollment ID: O20130917000758 |
| Entity Name | Chesterfield Cardiology Care, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134672587 PECOS PAC ID: 7315234598 Enrollment ID: O20161003001856 |
| Entity Name | Heart Care Specialists LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275031866 PECOS PAC ID: 2062774755 Enrollment ID: O20180316000334 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael Stephen Logue, FAM NRS PRAC FNP 11140 S Towne Square, Suite # 105, St Louis, MO 63123 Ph: (314) 894-0787 | Mr Michael Stephen Logue, FAM NRS PRAC FNP 10012 Kennerly Road, Suite # 301, St Louis, MO 63128 Ph: (314) 894-0787 |
Ms. Virginia Lorraine Sepich Clemons, RN CPNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1465 S Grand Blvd, St Louis, MO 63104 Phone: 314-577-5675 Fax: 314-268-5111 |
Ms. Jessica Lynn Latham, AGNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1133 Dunn Rd, Suite 2335, St Louis, MO 63136 Phone: 314-653-5007 Fax: 314-653-5007 |
Mrs. Cathy Hinton, ANP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4291 Parkview Place, St Louis, MO 63110 Phone: 314-454-8134 |
Mrs. Mary H Brice, RN BC ANP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3023 N Ballas Rd, Suite 500d Rheumatology & Internal Med Assoc Of West Co, St Louis, MO 63131 Phone: 314-567-4541 Fax: 314-569-3647 |
Ms. Shelly Ann Campbell, RN, ACNP, BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: #1 Barnes Jewish, St Louis, MO 63110 Phone: 314-362-6620 Fax: 314-362-6660 |
Cody Marie Eckelkamp, FNP, BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 621 S New Ballas Road, St Louis, MO 63141 Phone: 636-667-3425 |
Mrs. Carolyn D Philpot, GNP BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3660 Vista, St Louis, MO 63110 Phone: 314-977-6055 Fax: 314-771-8575 |