Individual provider Active NPI

Seth Faull, DO

  • Emergency Medicine Physician
  • Owensboro, KY
National Provider Identifier
1285124404
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
TP947 Issued in KY
Practice address
1201 Pleasant Valley Rd
Owensboro, KY 42303-9811
Phone
(270) 417-2000
NPI assigned
May 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X TP947 KY Primary

Addresses

Primary practice location

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

Mailing address

1718 Freeman Ave
Owensboro, KY 42301-4641
Phone (812) 881-6890

Other practice location 1

1638 Owen Dr # 138
Fayetteville, NC 28304-3424
Phone (910) 615-5095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220825001464 KY Practitioner - Emergency Medicine 9133478720 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc CurrentSince Aug 1, 2022 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group, Inc. Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1285124404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 FREEMAN AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014641",
            "telephone_number": "812-881-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PLEASANT VALLEY RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039811",
            "telephone_number": "270-417-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr # 138",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-5095",
            "fax_number": "910-615-9872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAULL",
        "first_name": "SETH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "TP947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.