Individual provider Active NPI

Dorothy Lynn Faulkner, FNP-BC

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1134523012
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18923 Issued in SC
Practice address
703 Palmetto Ave
Greenville, SC 29617-2823
Phone
(864) 905-2162
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18923 SC Primary

Addresses

Primary practice location

703 Palmetto Ave
Greenville, SC 29617-2823

Mailing address

703 Palmetto Ave
Greenville, SC 29617-2823
Phone (864) 905-2162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006000525 SC Order and Referring Only - Nurse Practitioner 6901225234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18923SCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1134523012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 PALMETTO AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296172823",
            "telephone_number": "864-905-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 PALMETTO AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296172823",
            "telephone_number": "864-905-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "DOROTHY",
        "middle_name": "LYNN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.