Larry Lee Wilson, MD - Medicare Obstetrics & Gynecology in Supply, NC

  1. Home
  2. Obstetrics & Gynecology
  3. NC
  4. Supply
Larry Lee Wilson, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Supply, North Carolina. His current practice location is 14 Doctors Cir, Suite 5, Supply, North Carolina. You can reach out to his office (for appointments etc.) via phone at (910) 754-9166.

Larry Lee Wilson is licensed to practice in North Carolina (license number 200601686) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356345094.

Contact Information

Larry Lee Wilson, MD
14 Doctors Cir, Suite 5,
Supply, NC 28462-4097
(910) 754-9166
(910) 754-2972

Map and Direction




Physician's Profile

Full NameLarry Lee Wilson
GenderMale
SpecialityObstetrics & Gynecology
Location14 Doctors Cir, Supply, North Carolina
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1356345094
  • Provider Enumeration Date: 06/10/2005
  • Last Update Date: 06/25/2010
  Medicare PECOS Information:
  • PECOS PAC ID: 4587562434
  • Enrollment ID: I20041213000331

Medical Identifiers

Medical identifiers for Larry Lee Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1356345094NPI-NPPES
L10281MedicaidSC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 16506 (South Carolina)Secondary
207V00000XObstetrics & Gynecology 200601686 (North Carolina)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Larry Lee Wilson allows following entities to bill medicare on his behalf.
Entity NameLow Country Womens Specialists
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1811957491
PECOS PAC ID: 4486648995
Enrollment ID: O20040408000976
Entity NameJames T Martin Jr Md
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679524888
PECOS PAC ID: 0446253645
Enrollment ID: O20060808000333
Entity NameFetter Health Care Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003827304
PECOS PAC ID: 9032215199
Enrollment ID: O20070507000192
Entity NameObhg South Carolina Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538457361
PECOS PAC ID: 7012182504
Enrollment ID: O20111212000681
Entity NameFetter Health Care Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982124301
PECOS PAC ID: 9032215199
Enrollment ID: O20171228002000
Entity NameFetter Health Care Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518454818
PECOS PAC ID: 9032215199
Enrollment ID: O20190118001672
Entity NameFetter Health Care Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659872059
PECOS PAC ID: 9032215199
Enrollment ID: O20190930000858
Entity NameUwh Of The Carolinas Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1639506470
PECOS PAC ID: 0042448169
Enrollment ID: O20210318002461
Entity NameFetter Health Care Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457007841
PECOS PAC ID: 9032215199
Enrollment ID: O20221012001595

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry Lee Wilson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Larry Lee Wilson, MD
Po Box 60447,
Charlotte, NC 28260-0447

Ph: (704) 754-9166		Larry Lee Wilson, MD
14 Doctors Cir, Suite 5,
Supply, NC 28462-4097

Ph: (910) 754-9166

Reviews and Comments


Obstetrics & Gynecology Doctors in Supply, NC

Susan Kady Wilson, M.D.
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 14 Doctors Cir, Suite 5, Supply, NC 28462
Phone: 910-754-9166    Fax: 910-754-2972
Dr. Diane Nicole Ballerino-regan, M.D.
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 20 Medical Campus Dr, Suite 205, Supply, NC 28462
Phone: 910-755-5260    Fax: 910-755-5263
Mr. Robert E Hassler, MD
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 14 Doctors Cir, Suite 5, Supply, NC 28462
Phone: 910-754-9166    Fax: 910-754-2972
Mr. Lindian J Swaim Jr., MD
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 14 Doctors Cir, Suite 5, Supply, NC 28462
Phone: 910-754-9166    Fax: 910-754-2972

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.