Elisha C Faulkner

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

614 Issued in TN

Practice address

1370 Rutledge LN
Union City, TN 38261-8655

Phone

(731) 389-9800

NPI assigned

Jun 15, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dynamix Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Milan, TN
  • NPI 1669619268
  NPD

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1083239057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 RUTLEDGE LN",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382618655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 RUTLEDGE LN",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382618655",
            "telephone_number": "731-389-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "ELISHA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ew James & Sons, Inc, Dba Ew James Pharmacy #70
• Family Cancer Center PLLC
• Family Practice,LLC
• Fast Pace Medical Clinic PLLC
• Fast Pace Medical Clinic PLLC
• Feet First Podiatry PC
• Roger Nifras Fernandez
• Robin Finch, PHARM D
• Luanna Fisher, PTA
• Sherrie Deanne Fitzgerald, RN

• Athletic Trainer in Union City, TN
• Providers in Union City, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.