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LOGAN BLAZE WILSON FNP-C
NPI 1124678305
Nurse Practitioner - Family in Plano, TX

Active since September 18, 2019PECOS Enrolled
6529 W PLANO PKWY STE D, PLANO, TX 75093(972) 781-1414 Get Directions Write a Review

NPPES record last updated: January 13, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 13, 2021, Oct 9, 2019, Sep 23, 2019 and 1 more (4 updates tracked since 2019).

About Logan Blaze Wilson Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LOGAN BLAZE WILSON FNP-C (NPI 1124678305) is an individual family provider in Plano, Texas, licensed in Texas (AP143063) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124678305
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLOGAN BLAZE WILSONCredential: FNP-C
Location Address6529 W PLANO PKWY STE DPlano, TX 75093-8262
Mailing Address6529 W Plano Pkwy Ste DPlano, TX 75093-8262 · (972) 781-1414
Phone(972) 781-1414
Sole ProprietorNo
Enumeration DateSeptember 18, 2019
Last NPPES UpdateJanuary 13, 20214 updates tracked since enumeration
NPPES CertifiedJanuary 13, 2021
✔ NPI 1124678305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · AP143063
6529 W PLANO PKWY STE D, Plano, TX 75093
Open in Google Maps ↗

Other Identifiers 2

OtherPENDINGTX · Bcbstx
MedicaidPENDINGTX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Logan Blaze Wilson Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Logan Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dallas Physician Medical Services For Children Inc
15 mi
Pediatrics
1935 MEDICAL DISTRICT DR
Dallas, TX 75235
  • Reassigned Medicare billing, Texas enrollment
  • 424 clinicians in this Medicare group
NPI 1194153650 (214) 456-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75093 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA MARIE SALGADO FNP-BC
Nurse Practitioner (Family)
6529 W PLANO PKWY STE D
PLANO, TX 75093
Collin County (972) 781-1414
BRADY FRANKLIN
Nurse Practitioner
6529 W PLANO PKWY STE D
PLANO, TX 75093
Collin County (972) 781-1414
LYNDA LEIGH PATTEN RNC, MSN, NNP-BC
Nurse Practitioner (Pediatrics)
6529 W PLANO PKWY STE D
PLANO, TX 75093
Collin County (972) 781-1414
ELIZABETH STEPHENSON FNP
Nurse Practitioner (Family)
6529 W PLANO PKWY STE D
PLANO, TX 75093
Collin County (972) 781-1414
SHELBY NICOLE WALKER RN, APRN, CPNP-PC
Nurse Practitioner (Pediatrics)
6529 W PLANO PKWY STE D
PLANO, TX 75093
Collin County (972) 781-1414

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Logan Wilson's NPI number?

The NPI number for Logan Wilson is 1124678305. It was assigned to this individual provider in the NPPES registry on September 18, 2019.

Where is Logan Wilson located?

Logan Wilson practices at 6529 W Plano Pkwy Ste D, Plano, TX 75093. The listed phone number is (972) 781-1414.

What is Logan Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Logan Wilson enrolled in Medicare?

Yes. Logan Wilson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Logan Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Logan Wilson reassigns Medicare benefits to Dallas Physician Medical Services For Children Inc (Dallas, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Logan Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Logan Wilson accept?

Health plans from UnitedHealthcare list Logan Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Logan Wilson was last updated on January 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.