Kellie A Faulk, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

9601607 Issued in NC

Practice address

1400 Westgate Center Drive
Suite 130
Winston Salem, NC 27103-3104

Phone

(336) 659-8703

Fax

(336) 659-8704

NPI assigned

Aug 19, 2005

Last updated

Dec 8, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Kellie L Or Leleux Faulk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1023000676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-659-8703",
            "fax_number": "336-659-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WESTGATE CENTER DRIVE",
            "address_2": "SUITE 130",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033104",
            "telephone_number": "336-659-8703",
            "fax_number": "336-659-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "KELLIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "9601607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891003P",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "FAULK",
            "middle_name": "L OR LELEUX",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suzan Rebekah Farris, MD
• Marc Randolph Farrow, PT
• Fast Access NC LLC
• John-Paul Fattorusso, DO
• Shaniya Faucette
• Kyndle Faulkner, PA-C
• Michelle Faulkner, RD
• Kathryn Favreau, MS, RD, LDN, CNSC
• Jennifer Marie Feagan, ACNP
• Guiseppi Feducia, DPT

• Endocrinology, Diabetes & Metabolism Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Endocrinology, Diabetes & Metabolism Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.