Farah A Fatani, MD

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Practice address

5415 Sugarloaf Pkwy 1108
#5853
Lawrenceville, GA 30043

Phone

(678) 505-1069

NPI assigned

Jun 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Holistic Essential Wellness LLC

  • Health Service Clinic/Center
  • Lawrenceville, GA
  • NPI 1316671290
  NPD Authorized official

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1194457796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 COLLINS HILL RD STE H",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 SUGARLOAF PKWY 1108",
            "address_2": "#5853",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "678-505-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATANI",
        "first_name": "FARAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahnaz Faroqui, M.D.
• Natalie Rae Farr, PT, DPT
• Vonda Lynn Farrar, MSN, RN, NP-C
• Jill Ann Farster - Lyew, D.D.S.
• Caryl Sue Fasnacht, LMT
• Valerie Faulckes, RN
• Kalli Kole Faulkner, D.O.
• Pablo David Faundez, LAPC
• Kasheen Fasha Faustin, AUD
• Favors Behavioral Health & Consulting Services, LLC

• Primary Care Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.