Individual provider Active NPI

Marvin Chad Faulkner, D.C.

  • Chiropractor
  • Mt Sterling, KY
National Provider Identifier
1013908722
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
249710 Issued in KY
Practice address
113 Maloney Way
Mount Sterling, KY 40353-9553
Phone
(859) 762-0009
Fax
(859) 305-1639
NPI assigned
Nov 2, 2005
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 249710 KY Primary
Chiropractor 111N00000X 8287 AZ

Addresses

Primary practice location

113 Maloney Way
Mount Sterling, KY 40353-9553

Mailing address

113 Maloney Way
Mount Sterling, KY 40353-9553
Phone (859) 762-0009

Other practice location 1

815 Quisenberry Ln
Winchester, KY 40391
Phone (859) 762-0009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050311000316 KY Practitioner - Chiropractic 3274585674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

113 Maloney Way
Mt Sterling, KY 40353-8510
Phone (859) 762-0009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249710KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chadwick Management PSC Chiropractor CurrentSince Jan 1, 2016 Accepting new patients
Taylor County Chiropractic Inc Chiropractor Past Accepting new patients
Taylor County Chiropractic and Rehabilitation LLC Chiropractor PastSince Jan 1, 2017 Accepting new patients
Core Health Group PC Chiropractor PastSince Dec 17, 2007 Accepting new patients
Dr James L Rehberger PC Chiropractor Past Accepting new patients

Locations

113 Maloney Way
Mt Sterling, KY 40353
Phone (859) 498-0011

220 Windsor Dr
Ste C
Mt Sterling, KY 40353
Phone (859) 576-4432

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1013908722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MALONEY WAY",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403539553",
            "telephone_number": "859-762-0009",
            "fax_number": "859-305-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MALONEY WAY",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403539553",
            "telephone_number": "859-762-0009",
            "fax_number": "859-305-1639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Quisenberry Ln",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "KY",
            "postal_code": "40391",
            "country_code": "US",
            "telephone_number": "859-762-0009",
            "fax_number": "859-305-1639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "MARVIN",
        "middle_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "249710",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.