DR. LARRY T WILSON (NPI# 1134121221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134121221 |
| Entity Type | Individual |
| Full Name | DR. LARRY T WILSON |
| Credential | MD |
| Practice Address |
701 S Morgan Ave Andrews SC 29510 |
| Mailing Address |
1075 N Fraser St Georgetown SC 29440 |
| Practice Telephone | 8432645253 |
| Practice Fax Number | 8432645970 |
| Mailing Telephone | 8435274442 |
| Mailing Fax Number | 8435274027 |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2009-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | TL32077 | SC | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0101231693 | VA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MD35689 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 5642205 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750869285 | Larry Colenzo Wilson | Counselor | 6224 N Inwood Rd, Shreveport, LA 71119-7213 | 2018-08-06 |
| 1992171086 | Larry Wilson | Chiropractor | 800 W Platt St Ste 2, Tampa, FL 33606-4112 | 2015-08-12 |
| 1528211232 | Larry James Wilson | Social Worker | 1572 Zephyr Ave, El Cajon, CA 92021-3560 | 2008-10-25 |
| 1538344908 | Larry Dwight Wilson Jr. | Counselor | 3020 18th St Suite 17, Catholic Charities, Columbus, NE 68601-4254 | 2008-01-04 |
| 1689749582 | Larry Flick Wilson | Preventive Medicine | Faa, Ace-300, 901 Locust Street, Rm 350, Kansas City, MO 64106 | 2006-11-24 |
| 1932297892 | Larry Don Wilson | Dentist | 2247 Helton Dr, Florence, AL 35630-1063 | 2006-10-10 |
| 1275541344 | Larry Bertram Wilson | Dentist | 721 W Arapaho Rd, #102, Richardson, TX 75080-4155 | 2006-08-04 |
| 1801819495 | Larry Al Wilson | Counselor | 2708 E Tanager Trl, Orange, TX 77632-0750 | 2006-07-25 |
| 1063918167 | Larry Wilson | Case Manager/Care Coordinator | 418 Center St, Wheelersburg, OH 45694-1712 | 2018-04-05 |
| 1801390273 | Larry Greg Wilson | Case Manager/Care Coordinator | 115 Private Road 977, Pedro, OH 45659-8608 | 2018-03-21 |
| Street Address |
701 S MORGAN AVE |
| City | ANDREWS |
| State | SC |
| Zip Code | 29510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720688807 | Selena Augustine Chamberlain | Nurse Practitioner | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2020-10-28 |
| 1881948834 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 701 S Morgan Ave, Suite A, Andrews, SC 29510-2959 | 2012-10-30 |
| 1033438189 | Lizina Blessing Green | Family Medicine | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2010-05-27 |
| 1023346681 | Georgetown Memorial Hospital | Clinic/Center | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2009-11-19 |
| 1912149287 | Patrick Steve Smith Jr. | Physical Therapy Assistant | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2009-04-01 |
| 1144401365 | Georgetown Health Group | Family Medicine | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2007-11-15 |
| 1104995372 | Georgetown Physician Associates, LLC | Clinic/Center | 701 S Morgan Ave, Andrews, SC 29510 | 2006-11-06 |
| 1144207382 | Thomas O Fort | Physician Assistant | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2005-12-29 |
| 1750367918 | Janis W Harvey | Nurse Practitioner | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2005-12-20 |
| 1730164229 | Bernard Lee Jones Jr. | Family Medicine | 701 S Morgan Ave, Georgetown Health Group Dba Andrews Medical Center, Andrews, SC 29510-2959 | 2005-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578948733 | Jessica Mont | Registered Nurse | 201 Olivia Road, Andrews, SC 29510 | 2015-07-29 |
| 1801219845 | St. James-santee Family Health Center, Inc. | Clinic/Center | 675 North Morgan Avenue, Andrews, SC 29510 | 2014-01-28 |
| 1861820896 | White Pine Land Company Inc | Pharmacy | 15 West Ashland Street, Andrews, SC 29510 | 2013-10-30 |
| 1952472284 | Gene Alan Ziegenhorn | Dentist | 902 S Morgan Ave, Unit 1, Andrews, SC 29510 | 2006-11-10 |
| 1184649055 | Reynolds Drug Strore Inc | Durable Medical Equipment & Medical Supplies | 7 S Morgan Ave, Andrews, SC 29510 | 2006-07-13 |
| 1124003074 | Alexander S. Hemingway | Chiropractor | 502 Brooks Rd, Andrews, SC 29510 | 2005-12-14 |
| 1952831505 | Train Up Speech Therapy Services, LLC | Spec/Tech, Pathology | 212 W. Main St., Andrews, SC 29510 | 2017-06-15 |
| 1609936368 | Hemingway Chiropractic | Chiropractor | 502 Brooks Rd, Andrews, SC 29510 | 2006-12-11 |
| 1497110381 | Tabetha Bentley | Nurse Practitioner | 675 N Morgan Ave, Andrews, SC 29510-2417 | 2015-12-21 |
| 1780141093 | Sherrie B Richardson | Family Medicine | 675 N Morgan Ave, Andrews, SC 29510-2417 | 2019-02-22 |
| Find all providers in zip 29510 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881122620 | Vivien Anne Ingram | Family Medicine | 606 Nw 16th St, Andrews, TX 79714-4620 | 2017-05-24 |
| 1033360995 | Luis Miguel Esparza | Family Medicine | 712 Hospital Dr, Andrews, TX 79714-3617 | 2008-10-08 |
| 1326081571 | Thomas Vann Clayton | Family Medicine | 2751 Business 19, Andrews, NC 28901-0550 | 2006-06-14 |
| 1669474391 | Bonnie Eugenia Muncy | Family Medicine | 700 Hospital Dr, Andrews, TX 79714-3638 | 2005-08-12 |
| 1184626749 | Paul M Slaughter | Family Medicine | 720 Hospital Dr, Andrews, TX 79714-3617 | 2005-08-12 |
| 1780141093 | Sherrie B Richardson | Family Medicine | 675 N Morgan Ave, Andrews, SC 29510-2417 | 2019-02-22 |
| 1972942209 | Alyssa D'nae Tochterman | Family Medicine | 700 Hospital Dr, Andrews, TX 79714-3638 | 2013-06-19 |
| 1023338464 | Satish Nayak, M.d., P.a | Family Medicine | 706 Hospital Dr, Andrews, TX 79714-3617 | 2010-06-08 |
| 1033438189 | Lizina Blessing Green | Family Medicine | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2010-05-27 |
| 1144401365 | Georgetown Health Group | Family Medicine | 701 S Morgan Ave, Andrews, SC 29510-2959 | 2007-11-15 |
| Find all providers in ANDREWS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.