Active NPI
Adam Christopher Faltersack
- Certified Registered Nurse Anesthetist
- Wright Patterson Afb, OH
National Provider Identifier
1235450222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 151959-030
- Practice address
- 4881 Sugar Maple Dr
88MDG/Sgos
Wright Patterson Afb, OH 45433-5546 - Phone
- (937) 257-0151
- NPI assigned
- Jun 14, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 151959-030 | WI | Primary |
Addresses
Primary practice location
4881 Sugar Maple Dr
88MDG/Sgos
Wright Patterson Afb, OH 45433-5546
Mailing address
88 MDG/SGHJ
4881 Sugar Maple Dr
Wpafb, OH 45433
Phone (937) 257-3474
Other practice location 1
51st Medical Group
Unit 2060
Apo, AP 96278-2060
Phone (505) 784-4190
Other practice location 2
673d Medical Group
5955 Zeamer Ave
Jber, AK 99506
Phone (907) 580-1815
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
| License | State | Type | Specialty |
|---|---|---|---|
| 151959-030 | WI | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1235450222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 MDG/SGHJ",
"address_2": "4881 SUGAR MAPLE DR",
"city": "WPAFB",
"state": "OH",
"postal_code": "45433",
"telephone_number": "937-257-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"address_2": "88MDG/SGOS",
"city": "WRIGHT PATTERSON AFB",
"state": "OH",
"postal_code": "454335546",
"telephone_number": "937-257-0151"
}
],
"practiceLocations": [
{
"address_1": "51st Medical Group",
"address_2": "Unit 2060",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AP",
"postal_code": "962782060",
"country_code": "US",
"telephone_number": "505-784-4190",
"country_name": "United States",
"address_type": "MIL"
},
{
"address_1": "673d Medical Group",
"address_2": "5955 Zeamer Ave",
"address_purpose": "LOCATION",
"city": "JBER",
"state": "AK",
"postal_code": "99506",
"country_code": "US",
"telephone_number": "907-580-1815",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FALTERSACK",
"first_name": "ADAM",
"middle_name": "CHRISTOPHER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-14",
"last_updated": "2023-08-02",
"certification_date": "2023-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "151959-030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wright Patterson Afb, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.