Individual provider Active NPI

Logan Brooks Sescilla, PA-C

  • Physician Assistant
  • Siler City, NC
National Provider Identifier
1346026903
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
101 Walmart Supercenter
Siler City, NC 27344-6755
Phone
(919) 633-3911
Fax
(919) 663-3011
NPI assigned
Sep 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NC Primary

Addresses

Primary practice location

101 Walmart Supercenter
Siler City, NC 27344-6755

Mailing address

PO Box 32785
Charlotte, NC 28232-2785
Phone (919) 633-3911

Other practice location 1

1011 High Point St
Randleman, NC 27317-7192
Phone (336) 498-0226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240209003838 NC Practitioner - Physician Assistant 3173966728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CDT HealthcareGroup PAC ID 2365701596, 7 clinicians

Practice addresses (Care Compare)

101 Walmart Supercenter
Siler City, NC 27344-6755
Phone (919) 663-3911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CDT Healthcare CurrentSince Feb 1, 2024 Accepting new patients

Locations

1011 High Point St
Randleman, NC 27317
Phone (336) 498-0226

101 Walmart Supercenter
Siler City, NC 27344
Phone (919) 663-3911

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1346026903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32785",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282322785",
            "telephone_number": "919-633-3911",
            "fax_number": "919-663-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WALMART SUPERCENTER",
            "city": "SILER CITY",
            "state": "NC",
            "postal_code": "273446755",
            "telephone_number": "919-633-3911",
            "fax_number": "919-663-3011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 High Point St",
            "address_purpose": "LOCATION",
            "city": "Randleman",
            "state": "NC",
            "postal_code": "273177192",
            "country_code": "US",
            "telephone_number": "336-498-0226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SESCILLA",
        "first_name": "LOGAN",
        "middle_name": "BROOKS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Siler City, NC

Sources for this page

Verify at the official NPI Registry.