Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1619202108 Individual Practitioner Male Practitioner

Dr. Cody R Wilson , DO

Pediatrics • North Logan, UT

Professional Overview & Biography Verified Profile Summary

Dr. Cody Wilson, DO is a registered healthcare professional specializing in Pediatrics in North Logan, UT. Practice services are available at 2380 N 400 E STE C under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2380 N 400 E Ste C

North Logan, UT 843411756

Telephone 4357537337
Fax 4357506779
Associated Practice Facility / Clinic
🏢 Primary Care Pediatrics Facility NPI 1588969539

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in North Logan, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.9 Yrs
Regional Practice Density
4 Specialists

Practicing in North Logan, UT (688 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License UT 8849510-1204

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License NE 6025

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Secondary Practice Locations

3001 Daggett Ave

Klamath Falls, OR 976011114

Phone: 5418514800

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1013973031

Doctor of Medicine (M.D.)

NPI 1295996700

Doctor of Osteopathic Medicine (D.O.)

NPI 1518589209

Doctor of Osteopathic Medicine (D.O.)

NPI 1558328427

Doctor of Medicine (M.D.)

NPI 1578520904

Doctor of Medicine (M.D.)

Stacie Mecham , PNP

Nurse Practitioner - Pediatrics

NPI 1598723470

Pediatric Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location October 02, 2019

Registered at 2380 N 400 E STE C, NORTH LOGAN, UT 843411756 (Tel: 4357537337)

📍
Updated Business Mailing Address October 02, 2019

Registered at 2380 N 400 E STE C, NORTH LOGAN, UT 843411756 (Tel: 4357537337)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2019

Pediatrics (License #8849510-1204 in UT)

NPI Profile Active July 01, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location July 01, 2013

Registered at 3001 DAGGETT AVE, KLAMATH FALLS, OR 976011114 (Tel: 5418514800)

📍
Updated Business Mailing Address July 01, 2013

Registered at PO BOX 5074, SIOUX FALLS, SD 571175074 (Tel: 6053286585)

👤
Provider Name / Credentials Updated July 01, 2013

Recorded as CODY WILSON, D.O.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2013

Pediatrics (License #6025 in NE)

🟢
Initial NPI Registration & Enumeration October 16, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619202108
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 16, 2009
Last Update: October 02, 2019
Sole Proprietor: No

Mailing Address

2380 N 400 E Ste C

North Logan, UT 843411756

Phone: 4357537337

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.