Michael Anton Facklmann, CRNFA

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

0001206848 Issued in VA

Practice address

1001 Blythe Blvd
Suite 300
Charlotte, NC 28203-5866

Phone

(704) 373-0212

Fax

(704) 373-2626

NPI assigned

Oct 22, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1386970515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-373-0212",
            "fax_number": "704-373-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-373-0212",
            "fax_number": "704-373-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACKLMANN",
        "first_name": "MICHAEL",
        "middle_name": "ANTON",
        "name_prefix": "Mr.",
        "credential": "CRNFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "VA",
            "license": "0001206848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Mosca Fabeny, M.A., L.P.C
• Katie Fabian, DPT
• Fabin Physical Therapy, LLC
• Kelsi Brooke Fabin, PT, DPT
• Austin Gerard Faccone, D.C.
• Jennifer Fadel, LCMHCA
• Yonis Mohamed Ahmed Fadlalmula
• Fafli Inc
• David Fafore, LCSW-A
• James Arthur Fagan, M.D.

• All providers in Charlotte, NC
• Registered Nurse First Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; 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.