0010-05100
Active
No
06/25/2014
11/10/2026
Active Supervisor
| Name | Type | Status | Approved | Inactive |
|
Mardis, Stacey Leigh, MD
| MD |
Active
|
04/24/2023
|
|
|
Misenar, Garik Traverse, MD
| MD |
Active
|
03/01/2022
|
|
|
Rody, Richard Brent, MD
| MD |
Active
|
03/16/2022
|
|
|
Tarleton, Gregory Paul, MD
| MD |
Active
|
06/12/2019
|
|
|
Verrilli, Albert Alexander, III, MD
| MD |
Active
|
05/01/2025
|
|
|
Wiggins, David Scott, MD
| MD |
Active
|
07/01/2024
|
|
North Carolina Hospital Admitting Privileges
| Location |
| Forsyth Medical Center |
| Novant Health Forsyth Medical Center |
| Novant Health Kernersville Medical Center |
| Thomasville Medical Center |
Out of State Active/Inactive Licenses
| State |
| Florida |
| South Carolina |
Out of Country Active/Inactive Licenses
Address
Liberty Medicare Advantage
2334 S. 41st st
Wilmington, NC 28403
910-918-0706
Information
PA School
| School | Graduation |
| Wake Forest University School of Medicine Physician Assistant Program | 2014 |
Area of Practice
| Area Of Practice | Primary |
| Emergency Medicine | |
| Geriatrics | Yes |
Current Membership in Medical Professional Organizations
Honors & Awards
| Honor/Award | Given By | Date |
| None Reported |
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 |