Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Larson Thomas Vickery, PA-C

Individual provider Physician Assistant · NPI 1477171494

Larson Thomas Vickery, PA-C is a Physician Assistant in Charlotte, North Carolina. Qualified in 2019, 7 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3545 Whitehall Park Dr Ste 300
Charlotte, NC 28273-4179
Phone: (980) 302-8850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 Hawthorne Ln, Charlotte, NC 28204-2515 — (704) 384-4000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-10264 (NC)

Record details

NPI number1477171494
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 7, 2020
Last updated in NPPESMay 30, 2023
Certification dateMay 30, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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