Janice Kay Faulkner, OPTICIAN OWNER

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DR3962 Issued in TX

Practice address

1223 5TH Ave
Fort Worth, TX 76104

Phone

(817) 870-1291

Fax

(817) 870-4928

NPI assigned

Feb 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fifth Avenue Eyewear

  • Optician
  • Fort Worth, TX
  • NPI 1023140860
  NPD (past) Authorized official

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1013050319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 5TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-870-1291",
            "fax_number": "817-870-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 5TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-870-1291",
            "fax_number": "817-870-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "JANICE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "OPTICIAN OWNER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "TX",
            "license": "DR3962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066429401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Faught, FNP-C
• Paige Ponthier Faulder, MS CCC-SLP
• Katelynn Faulk, PA
• Peter Faulk
• Jessica Jean Faulkenberry, DC, MSFN
• Krista M Faulkner, PT, DPT
• Abigail Elizabeth Faulman, MD
• Danielle Fauss, PT, DPT
• Macy Danielle Faust
• Benjamin Favela

• Optician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Optician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.