36221
Active
No
11/14/1992
06/06/2027
Active Supervisees
| Name | Type | Status | Approved | Inactive |
|
Betz, Karen Rose
| Physician Assistant |
Active
|
07/28/2026
|
|
|
Branch, Brittany Stroud
| Nurse Practitioner |
Active
|
06/19/2024
|
|
|
Brooks, Tasha Ivey
| Nurse Practitioner |
Active
|
09/24/2025
|
|
|
Courtleigh, Eileen Shannon
| Physician Assistant |
Active
|
04/28/2026
|
|
|
Freeman, Tekisha Rina
| Nurse Practitioner |
Active
|
08/10/2023
|
|
|
Locklear, Crystal Gail
| Nurse Practitioner |
Active
|
11/01/2023
|
|
|
Locklear, Phoenix
| Physician Assistant |
Active
|
04/28/2026
|
|
|
Norton, Joye Wallace
| Nurse Practitioner |
Active
|
07/24/2024
|
|
|
Patterson, Kimberly Shannel
| Nurse Practitioner |
Active
|
01/10/2024
|
|
|
Todd, Mary Ann
| Nurse Practitioner |
Active
|
05/18/2024
|
|
|
Weber, Terri Reno
| Physician Assistant |
Active
|
02/15/2019
|
|
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
| State |
| Michigan |
| North Carolina |
| South Carolina |
Out of Country Active/Inactive Licenses
Address
Wagram Family Practice
24420 Marlboro Street
Wagram, NC 28396
910-369-3631
Information
Mon-Fri
I treat many different problems and believe strongly in disease prevention.I also treat all ages from newborn to rhe very elderly.Hopefully I treat patients as I would want to be treated.
Yes
No
Yes
Yes
Medical School
| School | Graduation |
| MI State Univ. | 1988 |
Post Graduate Training
"Last Year" does not necessarily mean that the licensee completed his/her training program. (In NC, a physician can be licensed without completing such a program.)
| Institution | Specialty | State, Country | Training Program | Last Year |
| Bon Secours Hospital | Family Medicine |
MI, US
| Residency | 1991 |
| Detoit Osteopathic Hospital | Other - Internship |
MI, US
| Internship | 1989 |
Current Board Certification and Year of Certification/Recertification
Physicians should not list non-ABMS or non-AOA specialty boards unless the board meets the criteria set forth in the NC Medical Board’s Advertising and Publicity Position Statement.
| Primary/Subspecialty | Year |
| Family Medicine | 2023 |
Area of Practice
| Area Of Practice | Primary |
| Family Medicine | Yes |
| Family Practice (and OMT) | |
| Geriatric Medicine | |
Current Membership in Medical Professional Organizations
| Membership |
| American Academy of Family Physicians |
| American Osteopathic Association |
| NC Academy of Family Physicians |
Honors & Awards
| Honor/Award | Given By | Date |
| Resident Teacher Award | Bon Secours Hospital | 1991 |
Public Service
| Name of Clinic | Service Description | Date |
| None Reported |
Current Academic Appointments
| Title | Institution | City, State, Country |
| None Reported |
Publications
Section 1: Adverse Actions
North Carolina Medical Board Public Actions
| Date | Description | Link |
| None Reported |
Other Regulatory Board or Agency Public Actions
| Date | Name of Board/Agency | Action Taken | Link |
| None Reported |
Health Care Institution Suspensions and Revocations
| Date | Health Care Institution | Action Taken |
| None Reported |
Section 2: Administrative Actions
Actions listed in this section are considered non-disciplinary by the Board. In situations where
administrative actions are taken, the licensee may not have met certain statutory requirements or
may have failed to follow correct administrative procedures.
North Carolina Medical Board Reentry Agreement
| Date | Description | Link |
| None Reported |
North Carolina Special Purpose Licensing Agreement
| Date | Description | Link |
| None Reported |
Malpractice Information
The Board is currently reviewing the care that led to this payment.
| Incident Date | Payment Date | Area of Practice | City, State, Country | Response |
| None Reported |
Misdemeanor/DUI/DWI Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |
Felony Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |