Individual provider Active NPI

Ward M Faulkenberry, CFNP

  • Nurse Practitioner
  • Lancaster, SC
National Provider Identifier
1194721472
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F27646 Issued in SC
Practice address
201 W Meeting St
Ste a
Lancaster, SC 29720-2380
Phone
(803) 286-4666
Fax
(803) 289-6591
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F27646 SC Primary

Addresses

Primary practice location

201 W Meeting St
Ste a
Lancaster, SC 29720-2380

Mailing address

201 W Meeting St
Ste a
Lancaster, SC 29720-2380
Phone (803) 286-4666

Other identifiers 1

IdentifierTypeStateIssuer
HP0385MedicaidSC

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
I20100315000638 SC Practitioner - Nurse Practitioner 1759416852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1326SCMDProfessional Counselor
27646SCMDOphthalmology Physician
F27646SCMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1194721472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W MEETING ST",
            "address_2": "STE A",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202380",
            "telephone_number": "803-286-4666",
            "fax_number": "803-289-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W MEETING ST",
            "address_2": "STE A",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202380",
            "telephone_number": "803-286-4666",
            "fax_number": "803-289-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKENBERRY",
        "first_name": "WARD",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "F27646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HP0385",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

Verify at the official NPI Registry.