Nicole Marie Fava, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07893 Issued in NC

Practice address

111 Victoria Rd
Asheville, NC 28801-4811

Phone

(828) 252-7331

Fax

(828) 253-1123

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

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 2

Specialty

Physician Assistant

Education

Emory University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Cooper Physician Group LLCGroup PAC ID 1254775687, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health East Cooper Medical Center Hospital, Mount Pleasant, SC, CCN 420089

Merit-based Incentive Payment System (MIPS)

Final score

84.63 of 100Reported as group

Quality

80.11

Promoting interoperability

100

Improvement activities

40

Cost

68.65

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.fava.1@30548.direct.athenahealth.com

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.

• East Cooper Physician Group LLC

  • Internal Medicine Physician
  • Daniel Island, SC
  • NPI 1861253981
  Medicare reassignment Care Compare group
• Mission Medical Associates, Inc

  • Orthopaedic Surgery Physician
  • Hendersonville, NC
  • NPI 1649772583
  NPD
• East Cooper Physician Group LLC

  • Body Imaging Physician
  • Mt Pleasant, SC
  • NPI 1699641571
  NPD
• East Cooper Physician Group LLC

  • Obstetrics & Gynecology Physician
  • Mt Pleasant, SC
  • NPI 1922879469
  NPD
• East Cooper Physician Group LLC

  • Internal Medicine Physician
  • Summerville, SC
  • NPI 1982475604
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Cooper Medical Center LLC

  • General Acute Care Hospital
  • Mount Pleasant, SC
  • NPI 1841069044
  Care Compare affiliation

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1356457147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 HAW CREEK MEWS PL",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288057902",
            "telephone_number": "919-619-4837",
            "fax_number": "828-253-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VICTORIA RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014811",
            "telephone_number": "828-252-7331",
            "fax_number": "828-253-1123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Campus Health Service",
            "address_2": "101A Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275990001",
            "country_code": "US",
            "telephone_number": "919-966-6548",
            "fax_number": "919-843-4771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Campus Health Service",
            "address_2": "101A Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275990001",
            "country_code": "US",
            "telephone_number": "919-966-6548",
            "fax_number": "919-843-4771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAVA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINING LICENSE",
            "identifier": "0636",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydni Fasking
• Fastmed Holdings, PLLC
• Katlin Faulds
• Michael J Faulkner, LCSW
• Natalie Renee Faulkner, LCSW
• Loren Favale, DPT
• Allison Elizabeth Fay, PHARM.D.
• Dara Ashley Fazelnia, DO
• Ronald Anthony Fazio, LCSW
• John Fearing, P.A.-C

• Physician Assistant in Asheville, NC
• Providers in Asheville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.