Individual provider Active NPI

Sandra Jean Faulkner, DPH

  • Pharmacist
  • Hartsville, TN
National Provider Identifier
1023316171
Registry record updated Mar 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
C-6292 Issued in TN
Practice address
210 McMurry Blvd
Hartsville, TN 37074-1115
Phone
(615) 374-2438
Fax
(615) 374-3027
NPI assigned
Mar 13, 2011
Last updated
Mar 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X C-6292 TN Primary

Addresses

Primary practice location

210 McMurry Blvd
Hartsville, TN 37074-1115

Mailing address

210 McMurry Blvd
Hartsville, TN 37074-1115
Phone (615) 374-2438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C-6292TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1299974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299974400000",
    "number": "1023316171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MCMURRY BLVD",
            "city": "HARTSVILLE",
            "state": "TN",
            "postal_code": "370741115",
            "telephone_number": "615-374-2438",
            "fax_number": "615-374-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MCMURRY BLVD",
            "city": "HARTSVILLE",
            "state": "TN",
            "postal_code": "370741115",
            "telephone_number": "615-374-2438",
            "fax_number": "615-374-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "SANDRA",
        "middle_name": "JEAN",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-13",
        "last_updated": "2011-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "C-6292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2011; 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.