Logan Benedict

Athletic Trainer · Bolivar, MO

Individual Active NPI

NPI number 1508588088

Practice location

1155 W Parkview St
Bolivar, MO 65613-7801
Phone
(417) 777-7763

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NPI record

NPI
1508588088
Entity type
Individual (Type 1)
Enumeration date
September 13, 2022
Last updated
November 6, 2025
Certified
November 6, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X 2023035475 MO

Mailing address

659 Kays Point Rd
Lake Ozark, MO 65049-4779
Phone
(573) 723-0521

About Logan Benedict

Logan Benedict is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 1155 W Parkview St, Bolivar, MO 65613-7801. The NPI number 1508588088 was assigned on September 13, 2022 and the record was last updated on November 6, 2025.

Logan Benedict lists a license in the registry: #2023035475 (MO) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Logan Benedict?

The NPI number is 1508588088.

What is the phone number of Logan Benedict?

The phone number listed for the practice location is (417) 777-7763.

Where is Logan Benedict located?

1155 W Parkview St, Bolivar, MO 65613-7801.

What is the taxonomy code for Logan Benedict?

The primary taxonomy code is 2255A2300X – Athletic Trainer.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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