Individual provider Active NPI

Sheritia Tijuana Faulcon, MD

  • Psychiatry Physician
  • High Point, NC
National Provider Identifier
1023236965
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2007-00758 Issued in NC
Practice address
5209 W Wendover Ave
High Point, NC 27265-9177
Phone
(336) 899-1550
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2007-00758 NC Primary

Addresses

Primary practice location

5209 W Wendover Ave
High Point, NC 27265-9177

Mailing address

5209 W Wendover Ave
High Point, NC 27265-9177
Phone (336) 899-1550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address integratedcare@direct.daymarkrecovery.nextgenshare.com Direct Daymark Recovery Services Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20091117000563 NC Practitioner - Psychiatry 6709924459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of North Carolina at Chapel Hill School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daymark Recovery Services IncGroup PAC ID 0547233975, 132 clinicians

Practice addresses (Care Compare)

132 Poplar Grove Connector
Suite B
Boone, NC 28607-6121
Phone (828) 264-8759

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as group
Quality
89.03
Promoting interoperability
82
Improvement activities
40
Cost
90.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-00758NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Psychiatry CurrentSince Apr 25, 2012 Accepting new patients

Locations

132 Poplar Grove Connector
Ste B
Boone, NC 28607
Phone (828) 264-8759

5209 W Wendover Ave
High Point, NC 27265
Phone (336) 845-3988

101 Colvard St
Unit 1
Jefferson, NC 28640
Phone (336) 246-4542

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836

377 Hospital St
Ste 100
Mocksville, NC 27028
Phone (336) 751-0517

360 Beech St
Newland, NC 28657
Phone (828) 733-5889

1400 Willow Ln
North Wilkesboro, NC 28659
Phone (336) 667-5151

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: sheritia.faulcon.p1@direct.daymarkrecovery.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1023236965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 W WENDOVER AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659177",
            "telephone_number": "336-899-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 W WENDOVER AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659177",
            "telephone_number": "336-899-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULCON",
        "first_name": "SHERITIA",
        "middle_name": "TIJUANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2007-00758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "integratedcare@direct.daymarkrecovery.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Daymark Recovery Services Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "284 Executive Park Dr",
            "address_2": "Suite 100",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280251831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.