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Deactivated NPI 1114095437 Deactivated / Inactive NPI Male Practitioner

Dr. Larry Wayne Gardner , MD

Dermatology • Colville, WA

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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, Dr. Larry Gardner has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 04, 2006
NPI Deactivation Date December 12, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Larry Gardner, MD was a registered Dermatology practicing in Colville, WA. Throughout an active medical career spanning 18 years, Dr. Gardner provided care at the practice location at 143 GARDEN HOMES DR until profile deactivation on 2024-12-12.

Practice Location & Contact Primary Location

Practice Address

143 Garden Homes Dr

Colville, WA 991149229

Telephone 5096843701
Fax 5096845817
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Colville, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Colville, WA (397 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

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License NV 3301

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Practice Associates & Co-Workers

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

40 Associated Practitioners
Dr. Michael Snook , MD

Family Medicine

NPI 1033107149

Doctor of Medicine (M.D.)

Dr. Barry Bacon , MD

Family Medicine

NPI 1053309146

Doctor of Medicine (M.D.)

Jamie Mckinney , FNP-C

Nurse Practitioner - Family

NPI 1083502819

Family Nurse Practitioner (Certified)

NPI 1093163453

Doctor of Medicine (M.D.)

NPI 1093703100

Doctor of Medicine (M.D.)

NPI 1093703191

Doctor of Osteopathic Medicine (D.O.)

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 December 12, 2024

Record deactivated on December 12, 2024

NPI Profile Active April 23, 2010

NPI status registered as active in NPPES database

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Updated Practice Location April 23, 2010

Registered at 143 GARDEN HOMES DR, COLVILLE, WA 991149229 (Tel: 5096843701)

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Updated Business Mailing Address April 23, 2010

Registered at 1200 E COLUMBIA AVE, COLVILLE, WA 991143354 (Tel: 5096843701)

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Provider Name / Credentials Updated April 23, 2010

Recorded as LARRY GARDNER, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2010

Dermatology (License #3301 in NV)

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Initial NPI Registration & Enumeration December 04, 2006

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: 1114095437
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 04, 2006
Last Update: April 23, 2010
Deactivation Date: December 12, 2024

Mailing Address

1200 E Columbia Ave

Colville, WA 991143354

Phone: 5096843701

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.