Individual provider Active NPI

Maria Alejandra Faulk, O.D.

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1285910786
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2255 Issued in NC
Practice address
9820 Callabridge CT
Charlotte, NC 28216-7669
Phone
(704) 394-3886
Fax
(704) 392-3699
NPI assigned
Oct 27, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002471 PA
Optometrist 152W00000X 2255 NC Primary

Addresses

Primary practice location

9820 Callabridge CT
Charlotte, NC 28216-7669

Mailing address

307 Ethan LN
Belmont, NC 28012-4116
Phone (919) 749-9891

Other identifiers 1

IdentifierTypeStateIssuer
5920812MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120523000362 NC Practitioner - Optometry 2961665294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Corte and Wruble, OD, PLLCGroup PAC ID 5294002689, 15 clinicians

Practice addresses (Care Compare)

6801 Northlake Mall Dr
Suite 253
Charlotte, NC 28216-0757
Phone (704) 509-4490

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2255NCMDBehavioral Analyst
OEG002471PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Corte and Wruble, OD, PLLC Optometrist CurrentSince Nov 26, 2024 Accepting new patients
South Fork Optometric Associates, P.a. Optometrist Past Accepting new patients
Weitzel & Associates PA Optometrist PastSince Jan 25, 1999 Accepting new patients

Locations

6801 Northlake Mall Dr
Ste 253
Charlotte, NC 28216
Phone (704) 509-4366

8111 Concord Mills Blvd
Ste 359
Concord, NC 28027
Phone (980) 258-6038

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": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1285910786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 ETHAN LN",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280124116",
            "telephone_number": "919-749-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 CALLABRIDGE CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282167669",
            "telephone_number": "704-394-3886",
            "fax_number": "704-392-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "MARIA",
        "middle_name": "ALEJANDRA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002471",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920812",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.