Individual provider Active NPI

Tabreeka M Faulkner, RN

  • Registered Nurse
  • Riverdale, GA
National Provider Identifier
1356094130
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN226990 Issued in GA
Practice address
7583 Chancey LN
Riverdale, GA 30296-1449
Phone
(678) 596-0137
NPI assigned
Feb 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN226990 GA
Continence Care Registered Nurse 163WC2100X RN226990 GA
Diabetes Educator Registered Nurse 163WD0400X RN226990 GA
Enterostomal Therapy Registered Nurse 163WE0900X RN226990 GA
Home Health Registered Nurse 163WH0200X RN226990 GA
Infusion Therapy Registered Nurse 163WI0500X RN226990 GA
Infection Control Registered Nurse 163WI0600X RN226990 GA
Nutrition Support Registered Nurse 163WN1003X RN226990 GA
Pain Management Registered Nurse 163WP0000X RN226990 GA
Wound Care Registered Nurse 163WW0000X RN226990 GA
Orthopedic Registered Nurse 163WX0800X RN226990 GA
Ostomy Care Registered Nurse 163WX1500X RN226990 GA
Registered Nurse 163W00000X RN226990 GA Primary

Addresses

Primary practice location

7583 Chancey LN
Riverdale, GA 30296-1449

Mailing address

7583 Chancey LN
Riverdale, GA 30296-1449
Phone (678) 596-0137

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN226990GAMDContinence Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1356094130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7583 CHANCEY LN",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961449",
            "telephone_number": "678-596-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7583 CHANCEY LN",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961449",
            "telephone_number": "678-596-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "TABREEKA",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WC2100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continence Care",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WI0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infection Control",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "GA",
            "license": "RN226990",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN226990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.