Individual provider Active NPI

Jesse Dewayne Faulk

  • Internal Medicine Physician
  • Huntsville, AL
National Provider Identifier
1013443183
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.37668 Issued in AL
Practice address
301 Governors Dr SW
Huntsville, AL 35801-5123
Phone
(256) 536-5511
NPI assigned
May 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.37668 AL Primary

Addresses

Primary practice location

301 Governors Dr SW
Huntsville, AL 35801-5123

Mailing address

301 Governors Dr SW
Huntsville, AL 35801-5123
Phone (256) 536-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721003154 AL Practitioner - Internal Medicine 5395009914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Valley FoundationGroup PAC ID 0345130118, 31 clinicians

Practice addresses (Care Compare)

301 Govenors Dr SW
Huntsville, AL 35801-5123
Phone (256) 536-5511

Hospital & facility affiliations

  • Huntsville Hospital Homecare Home health agency, Huntsville, AL, CCN 017119
  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as apm
Quality
82.81
Promoting interoperability
83.07
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4605ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Valley Foundation CurrentSince Aug 1, 2020 Accepting new patients
The Health Care Authority of the City of Huntsville Past Accepting new patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients

Locations

301 Governors Dr SW
Huntsville, AL 35801
Phone (256) 536-5511

Interoperability endpoints

  • Direct secure messaging: jessefaulk@uab.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1013443183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 GOVERNORS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015123",
            "telephone_number": "256-536-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GOVERNORS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015123",
            "telephone_number": "256-536-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "JESSE",
        "middle_name": "DEWAYNE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.37668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.