Individual provider Active NPI

Logan Michaeline Kwasnicka, PA-C

  • Physician Assistant
  • Wadsworth, OH
National Provider Identifier
1619346269
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004463 Issued in OH
Practice address
1348 Sharon Copley Rd
Wadsworth, OH 44281
Phone
(330) 591-2444
Fax
(833) 740-3510
NPI assigned
Sep 24, 2015
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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 004463 OH Primary

Addresses

Primary practice location

1348 Sharon Copley Rd
Wadsworth, OH 44281

Mailing address

PO Box 62
Sharon Center, OH 44274-0062
Phone (724) 815-8511

Other names 1

  • Logan Rock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Oct 1, 2020 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004463OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health Express Urgent Care Centers,LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1619346269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62",
            "city": "SHARON CENTER",
            "state": "OH",
            "postal_code": "442740062",
            "telephone_number": "724-815-8511",
            "fax_number": "833-740-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 SHARON COPLEY RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "44281",
            "telephone_number": "330-591-2444",
            "fax_number": "833-740-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWASNICKA",
        "first_name": "LOGAN",
        "middle_name": "MICHAELINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2025-07-09",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "004463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOGAN",
            "last_name": "ROCK",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.