STACI A LOGUE-JOHNSON (NPI# 1922014646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922014646 |
| Entity Type | Individual |
| Full Name | STACI A LOGUE-JOHNSON |
| Credential | PA-C |
| Practice Address |
5150 Journal Center Blvd Ne Albuquerque NM 87109-5900 |
| Mailing Address |
933 Bradbury Dr Se Suite 2222 Albuquerque NM 87106-4374 |
| Practice Telephone | 5052627223 |
| Mailing Telephone | 5052722345 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2018-02-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
PA2003-0020 | NM | Allopathic & Osteopathic Physicians |
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
PA2003-0020 | NM | Allopathic & Osteopathic Physicians |
| Street Address |
5150 JOURNAL CENTER BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-5900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230135 | Cecilia L Concepcion | Pediatrics | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2005-07-21 |
| 1790200392 | Ronald Mark Edwards | Nurse Practitioner | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109 | 2017-08-04 |
| 1154859882 | Theresa Marie Toomey | Nurse Practitioner | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2017-05-25 |
| 1972037695 | Susan Teresa Rossi | Pharmacist | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2017-04-19 |
| 1104350602 | Julie Marie Gibson | Registered Nurse | 5150 Journal Center Blvd Ne, Davita Medical Group Coumadin Clinic, Albuquerque, NM 87109-5900 | 2017-04-12 |
| 1710426085 | Luz Lavezo | Pharmacist | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2017-02-19 |
| 1124561790 | Arlette Marie Atencio | Nurse Practitioner | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2016-11-29 |
| 1699169912 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2015-03-25 |
| 1083020846 | Kelsey Hornsby | Pharmacist | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2014-07-01 |
| 1982019097 | Jayce Powell | Nurse Practitioner | 5150 Journal Center Blvd Ne, 2nd Floor Hand Clinic, Albuquerque, NM 87109-5900 | 2014-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780869743 | Nathan Dean Nielsen | Internal Medicine | Msc10-5550 1 University of New Mexico, Albuquerque, NM 87131 | 2008-01-08 |
| 1245255835 | Michel A Boivin | Internal Medicine | 5-acc Msc 10 5550, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-07-13 |
| 1295706331 | Harold Lawrence Groff | Internal Medicine | University of New Mexico Medical Center, Msc11 6093, Albuquerque, NM 87106 | 2006-01-27 |
| 1922574508 | Richard Morgan Harlyn | Internal Medicine | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2018-10-22 |
| 1801311907 | Sara Katelynn Lucero | Internal Medicine | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2017-08-09 |
| 1487996427 | Tyler Ray Shackelford | Internal Medicine | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2013-03-16 |
| 1407141815 | Sarah Kathleen Medrek | Internal Medicine | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5153 | 2011-06-14 |
| 1992844922 | Eleana M Zamora | Internal Medicine | Unm Hospital Internal Medicine, 2211 Lomas Blvd Ne Msc 10-5550, Albuquerque, NM 87131-0001 | 2007-02-06 |
| 1760577241 | Chang-kun Charles Choi | Internal Medicine | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2006-10-03 |
| 1336155084 | Betty Chang | Internal Medicine | 2211 Lomas Blvd Ne, Div. Pulm/cc Medicine, Msc 10-5550, Albuquerque, NM 87106-2745 | 2006-08-01 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
Please comment or provide details below to improve the information on STACI A LOGUE-JOHNSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.