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Deactivated NPI 1366653305 Deactivated / Inactive NPI Male Practitioner

Larry G Wardlow , PA

Physician Assistant • Augusta, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Larry Wardlow has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 24, 2007
NPI Deactivation Date October 06, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Larry Wardlow, PA was a registered Physician Assistant practicing in Augusta, GA. Throughout an active medical career spanning 16 years, Larry Wardlow provided care at the practice location at 3624 J DEWEY GRAY CIR STE 110 until profile deactivation on 2023-10-06.

Practice Location & Contact Primary Location

Practice Address

3624 J Dewey Gray Cir Ste 110

Augusta, GA 309096585

Telephone 7066512667
Fax 7066512670

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Augusta, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.3 Yrs
State Avg: 12.9 Yrs
Regional Practice Density
234 Specialists

Practicing in Augusta, GA (4726 Statewide)

Telehealth Adoption Rate
4.7% 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

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License GA 004453

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Denise Drake , NP

Nurse Practitioner

NPI 1114138013

Nurse Practitioner

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated October 06, 2023

Record deactivated on October 06, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 3624 J DEWEY GRAY CIR STE 110, AUGUSTA, GA 309096585 (Tel: 7066512667)

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Updated Business Mailing Address July 08, 2007

Registered at 228 FOREST PINES RD, AIKEN, SC 298032752 (Tel: 8036438097)

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Provider Name / Credentials Updated July 08, 2007

Recorded as LARRY WARDLOW, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #004453 in GA)

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Initial NPI Registration & Enumeration May 24, 2007

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: 1366653305
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 24, 2007
Last Update: July 08, 2007
Deactivation Date: October 06, 2023

Mailing Address

228 Forest Pines Rd

Aiken, SC 298032752

Phone: 8036438097

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.