KENNETH DALE WENSLOW (PA) – Physician Assistant, NPI 1295805661
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KENNETH DALE WENSLOW (PA)
49 Gordon Rd
Suite 102
Jasper, GA 30143
Phone: (470) 299-1998
Fax: (470) 299-1898
Type: Location
12389, Crabapple Road, Alpharetta, Fulton County, Georgia, 30004, United States
ALPHARETTA, GA 300046328
Phone: (470) 299-1998
Fax: (470) 299-1898
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 35 Open Payments records for all available years, with a total value of $2,491.
Total Amount is formed as General ($2,491) + Research ($0) + Ownership ($0) = $2,491.
Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Medtronic, Inc. ($1,986).
Total Amount
$2,491
General + Research + Ownership
Payments
35
Total payment records
General Amount
$2,491
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $1,986 |
| ABBVIE INC. | $145 |
| TerSera Therapeutics LLC | $88 |
| Salix Pharmaceuticals, a division of Bausch Health US, LLC | $70 |
| Averitas Pharma Inc. | $46 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-10-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (954 days ago).
Enrollment records
1
Earliest due date
2023-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041008000768 | I | Physician Assistant | GA | 2023-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30143)
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