Individual provider Active NPI

Larry A Widner, M.D.

  • Specialist
  • High Point, NC
National Provider Identifier
1215915210
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
28380 Issued in NC
Practice address
624 Quaker LN
Suite 117-B
High Point, NC 27262-3832
Phone
(336) 882-1416
Fax
(336) 882-7691
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 28380 NC Primary

Addresses

Primary practice location

624 Quaker LN
Suite 117-B
High Point, NC 27262-3832

Mailing address

PO Box 5007
High Point, NC 27262-5007
Phone (336) 882-1416

Other identifiers 2

IdentifierTypeStateIssuer
8987271MedicaidNC
87271OtherNCBCBSNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28380NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Radiology Associates PLLC Past Accepting new patients
Wake Forest Health Network, LLC PastSince Jan 1, 1990 Accepting new patients
High Point Radiological Services Past Accepting new patients
Cornerstone Health Care PA PastSince Jan 1, 1990 Accepting new patients
Cornerstone Health Care LLC PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215915210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5007",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272625007",
            "telephone_number": "336-882-1416",
            "fax_number": "336-882-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 QUAKER LN",
            "address_2": "SUITE 117-B",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623832",
            "telephone_number": "336-882-1416",
            "fax_number": "336-882-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDNER",
        "first_name": "LARRY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "28380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8987271",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "87271",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.