LOGAN BALKCOM – Anesthesiologist Assistant, NPI 1891457768

LOGAN BALKCOM is a healthcare provider. based in Tifton, Georgia. specializing in ANESTHESIOLOGY ASSISTANT. They hold a License No. 10709 (GA). The NPI Number for LOGAN BALKCOM is 1891457768

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
LOGAN BALKCOM
NPI
1891457768
Phone
(229) 382-7120
Address
901 18TH ST E
Enumeration Date
8 October 2021
Last Update Date
8 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2293827120
Graduation Year
2021 (5 years ago)
PAC ID
7517365018
Group Practice PAC ID
2062745169
Professional Enrollment ID
I20211014000554
Address ID
GA317943648TI901XXEXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,383 ANESTHESIOLOGY ASSISTANT in GA

Provider Addresses for LOGAN BALKCOM

  • 901 18TH ST E

    TIFTON, GA 317943648

    Phone: (229) 382-7120

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $38.

Total Amount is formed as General ($38) + Research ($0) + Ownership ($0) = $38.

Last reported payment date: 2024-10-13 • Largest payer in this snapshot: Medtronic, Inc. ($20).

Total Amount

$38

General + Research + Ownership

Payments

2

Total payment records

General Amount

$38

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-10-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211014000554IAnesthesiology AssistantGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00812Anesthesia for exam of colon using an endoscope1818$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1717$0
View full utilization report →

Insurance plans in this area (ZIP 31794)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062745169View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerGA
-GA
Nurse PractitionerGA
-GA
-GA
Nurse PractitionerGA
Family Practice, Emergency MedicineGA
Internal Medicine, Critical Care (Intensivists), Pulmonary Disease, Pulmonary DiseaseMD
-GA

Reviews

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Frequently asked questions

Does LOGAN BALKCOM have a public NPI I can cite?
Public records show LOGAN BALKCOM under NPI 1891457768.
Is LOGAN BALKCOM's NPI status active today?
Active status means LOGAN BALKCOM's NPI record is not deactivated in the public file.
What type of care does LOGAN BALKCOM provide?
LOGAN BALKCOM's profile centers on Anesthesiologist Assistant. Clinical services aligned with this taxonomy classification.
Is LOGAN BALKCOM tied to Tifton, Georgia?
If you are local to Tifton, Georgia, LOGAN BALKCOM may be relevant to your search.
Why is information missing for LOGAN BALKCOM?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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