Marisa Scarlett Faircloth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

100709 Issued in NC

Practice address

1419 National Hwy
Midway Plaza
Thomasville, NC 27360-2319

Phone

(336) 889-7213

Fax

(336) 889-7216

NPI assigned

Apr 15, 2009

Last updated

May 12, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marisa Scarlett Former name

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1356440663
  Medicare reassignment
• Mid-South Pain Management, PC

  • Pain Medicine Physician
  • Winchester, TN
  • NPI 1346315710
  NPD (past)

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1386887727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1226",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370651226",
            "telephone_number": "615-591-2732",
            "fax_number": "615-591-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 NATIONAL HWY",
            "address_2": "MIDWAY PLAZA",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273602319",
            "telephone_number": "336-889-7213",
            "fax_number": "336-889-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCLOTH",
        "first_name": "MARISA",
        "middle_name": "SCARLETT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "100709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "SCARLETT",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Efua Mairo Erbynn, M.D
• Sharon Kay Eubank-Zavaleta, RPH
• Franklin R Everhart, PA
• Evernorth Direct Health LLC
• Everyage (Piedmont Crossing)
• Faith and Hope House (residental treatment facility)
• Debbie C Fanary
• Elizabeth Ann Faulkner
• June Anne Fawcett-Hardy
• David Fields

• Physician Assistant in Thomasville, NC
• Providers in Thomasville, 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 May 12, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.