Arnold William Facklam III, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APRN9420829 Issued in FL

Practice address

5216 Clayton Court
Fort Myers, FL 33907

Phone

(239) 343-8260

Fax

(239) 343-8261

NPI assigned

May 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, GA2 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

Nurse Practitioner

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Apogee Medical Group GeorgiaGroup PAC ID 4587676945, 122 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122

Merit-based Incentive Payment System (MIPS)

Final score

87.29 of 100Reported as group

Quality

70.79

Improvement activities

40

Cost

81.32

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Apogee Medical Group Georgia

  • Internal Medicine Physician
  • Carrollton, GA
  • NPI 1629025143
  Medicare reassignment Care Compare group NPD
• SMH Physician Services Inc

  dba First Physicians Group

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292
  Medicare reassignment NPD

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

• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1356509129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-8260",
            "fax_number": "239-343-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5216 CLAYTON COURT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "239-343-8260",
            "fax_number": "239-343-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACKLAM",
        "first_name": "ARNOLD",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN325609",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN9420829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016126500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN OBS ASSOCIATES U OF R",
            "identifier": "J400001352",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Fabian, LMFT
• Camila Shaiel Fabius
• Sarah Elizabeth Fabrizi, OTR/L
• Jordan Antonio Facey, PA-C
• Melissa Facey
• Tomas V Factora, M.D.
• Fadoir Psychological Services, LLC
• Beatrice L Fagel-Factora, M.D.
• Mohamed Moosa Faisal, M.D.
• Laura Fajardo Turrent

• Acute Care Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.